Rujuk EIA Report PDF

Environmental Impact Assessment: Surgical Hospital, Sukkur
010/2011
CONTENTS
1.
EXECUTIVE SUMMARY
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
Project Description
Physical and Biological Environments
Socio-Economic Environment
Environmental Impact Assessment
Environmental Concerns
Positive Impacts
Environmental and Social Costs
Compensation and Resettlement
Environmental Management and Monitoring
Conclusions
2.
INTRODUCTION
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
2.10
Project Location
Objectives of the Project
Scope of Work
Project Proponents
Project Designers/Consultants
Construction Contractor
Environmental Consultants
Project Justification
Contact Persons
Document Structure
3.
APPROACH AND METHODOLOGY
3.1
3.2
3.3
Aims and Objectives of the Environmental Impact Assessment

Scope of the Study
Study Methodology
3.3.1
3.3.2
3.4
3.5
3.6
3.7
3.8
3.9
3.10
3.11
3.12
Inception Procedures
Document Resources
Reporting
Census Survey of Affected Persons
Resettlement Issues
Public Consultation
Assessment of Environmental and Social Impacts
Consultation with the Proponents
Consultation with EPA
Field Visits
Study Team
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4.
REGULATORY FRAMEWORK
4.1
4.2
4.3
Constitutional Provision
Policy Framework
Laws and Regulations
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4.3.1 Pakistan Environmental Protection Act, 1997

4.3.2 Pakistan Environmental Protection Agency
Review of Initial Environmental Examination and
Environmental Impact Assessment Regulations, 2000
4.3.3 National Environmental Quality Standards, 2000
4.3.4 Pakistan Penal Code, 1860
4.3.5 Sindh Local Government Ordinance, 2001
4.3.6 Land Acquisition Act, 1894
4.3.7 National Resettlement Policy
4.3.8 Project Implementation and
Resettlement of Affected Persons Ordinance, 2001
4.3.9 Sindh Building Control Ordinance, 1979
4.3.10 Sindh Wildlife Protection Ordinance, 1972
4.3.11 Hazardous Substances Rules, 2003
4.3.12 Hospital Waste Management Rules, 2005
4.3.13 Forest Act, 1927
4.3.14 the Cutting of Trees (Prohibition) Act, 1975
4.3.15 Protection of Trees and Brushwood Act, 1949
4.3.16 Employment of Child Act, 1991
4.3.17 Antiquities Act, 1975
4.3.18 Related Laws
4.3.19 Labour Laws
4.3.20 Environmental Guidelines
4.4
4.5
4.6
4.7
International Law and Standards

Equator Principles
Obligations Under International Treaties
Institutional Setup
5.
DESCRIPTION OF THE PROJECT
5.1
5.2
5.3
5.4
5.5
5.6
Project Overview
Alternate Sites
Objectives of the Project
Project Site
Building Regulations
Project Components and Activities
5.6.1
5.6.2
5.6.3
5.6.4
5.6.5
Land Acquisition
Surveying and Site Investigations
Design and Engineering
Selection of Contractor
Site Preparation
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5.6.6 Construction
5.6.7 Finishing and Furnishing
5.6.8 Services
5.6.9 Operation of the Project
5.7
5.8
5.9
Size and Magnitude of the Operation

Covered Area and Distribution
Construction Phase of the Project
5.9.1
5.9.2
5.9.3
5.9.4
5.9.5
5.9.6
5.9.7
5.10
Contracting Arrangements
Vehicles and Equipment
Emissions and Discharges
Construction Materials
Other Supplies
Waste Management Contractor
Waste Streams
Operational Phase of the Project

5.10.1 Demands on Services
5.10.2 Water Usage
5.10.3 Wastewater Generation
5.10.4 Water Balance
5.10.5 Water Tank
5.10.6 Disposal of Sewerage
5.10.7 Vehicular Traffic
5.10.8 Solid Waste
5.10.9 Wastewater Treatment Plant
5.10.10 Waste Management Team
5.10.11 Waste Management Plan
5.10.12 Incinerator
5.10.13 Waste Management Contractor
5.10.14 Elevators
5.10.15 Generators
5.10.16 Air-conditioning Plant
5.10.17 Vibrations
5.10.18 Noise
5.10.19 Reflection, Heat and Insulation
5.10.20 Services
5.10.21 Access
5.10.22 Storm Water System
5.11
5.12
Seismic Provisions
Safety of the Structure
5.12.1 Geotechnical and Soil Tests
5.12.2 Foundations
5.12.3 Piling
5.12.4 Bearing Capacity
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5.12.5 Chemical Contents

5.12.6 Structural Stability
5.13
5.14
5.15
5.16
5.17
Soil Amplification Study

Government Approvals, MOUs and Leases
Ecologically Critical and Sensitive Areas
Restoration and Rehabilitation
Proposed Schedule for Implementation
6.
DESCRIPTION OF THE ENVIRONMENT
6.1
6.2
Environmental Setting
Physical Resources
6.2.1
6.2.2
6.2.3
6.2.4
6.2.5
6.2.6
6.2.7
6.2.8
6.2.9
6.2.10
6.2.11
6.2.12
6.2.13
6.2.14
6.2.15
6.2.16
6.2.17
6.2.18
6.2.19
6.3
Ecological Resources
6.3.1
6.3.2
6.3.3
6.4
Geology and Geomorphology

Seismology
Land Use
Hydrology
Water Table
Soil
Topography
Climate
Seasons
Rainfall
Humidity
Monthly Mean Temperatures
Wind Direction and Speed
Visibility
Surface and Groundwater Resources
Surface and Groundwater Quality
Soil Contamination
Present State of the Habitat
Ambient Air Quality
Flora
Fauna
Threats to Flora and Fauna
Socio-Economic Environment
6.4.1
6.4.2
6.4.3
6.4.4
6.4.5
6.4.6
6.4.7
Demography
Education
Public Health
Power Sources and Transmission
Infrastructure
Road Network
Transportation
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6.4.8 Industries
6.4.9 Agriculture
6.4.10 Livestock
6.4.11 Forests
6.4.12 Irrigation and Drainage
6.4.13 Land Use Planning
6.4.14 Mineral Development
6.5
Quality of Life Values

6.5.1 Cultural Values
6.5.2 Socio-economic Values
6.5.3 Aesthetic Values
6.5.4 Recreation and Archaeological/Historical Treasures
7.
ENVIRONMENTAL IMPACT ASSESSMENT
7.1
Impact Assessment Methodology

7.1.1
7.1.2
7.1.3
7.1.4
7.1.5
7.2
7.3
7.4
Definition of the Criteria for Determining Significance

Prediction of the Magnitude of Potential Impacts
Identification of Mitigation Measures
Evaluation of the Residual Impact
Identification of Monitoring Requirements
Environmental Screening of the Proposed Project

Environmental Impact Classification
Environmental Problems Due To Project Location
7.4.1 Siting and Adjacent Land-uses
7.4.2 Displacement of Other Site Users
7.4.3 Local Environment
7.4.4 Availability of Existing Infrastructure
7.4.5 Depletion of Resources
7.5
7.6
Environmental Problems Related To Design

Environmental Problems Associated with Construction
7.6.1
7.6.2
7.6.3
7.6.4
7.6.5
7.6.6
7.6.7
7.6.8
7.6.9
7.6.10
7.6.11
Acquisition of Land
Selection of Contractor
Environment Friendly Construction Drills
Soil Contamination, Erosion and Degradation
Air Quality Deterioration
Noise Pollution
Surface Water and Groundwater Contamination
Construction Labour
Safety Hazards, Public Health and Nuisances
Damage to Infrastructure
Increase in Vehicular Traffic
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7.6.12
7.6.13
7.6.14
7.6.15
7.6.16
7.6.17
7.6.18
7.7
7.8
Dewatering and Drainage

Erosion Control
Temporary Excavations
Rollers
Blocked Access
Gender Issues
Site of Archaeological or Historical Significance
Health and Occupational Safety

Environmental Problems from Project Operations
7.8.1
7.8.2
7.8.3
7.8.4
7.8.5
7.8.6
7.8.7
7.8.8
7.8.9
7.8.10
7.8.11
7.8.12
7.8.13
Earthquake Hazard
Visual Impact
Noise
Shadow
Increase in Vehicular Traffic
Water Consumption
Water Conservation
Wastewater and Sewerage
Surface Drainage
Contamination of Soil, Surface and Groundwater
Obtrusive Light
Safety Hazards, Public Health and Nuisances
Vibrations
8.
ENVIRONMENTAL MANAGEMENT
8.1
8.2
8.3
Security
Vehicle Parking
Environmental Enhancement Measures
8.3.1
8.3.2
8.3.3
8.3.4
8.3.5
8.3.6
8.3.7
8.3.8
8.3.9
8.4
117
Energy Conservation
Environment-friendly Equipment
Solar or Wind Energy
Quality Control
Minimisation of Liquid and Solid Waste
Inflow of Natural Light
Circulation of Fresh Air
Reduction of Obtrusive Light
Plantations and Landscaping
Green Building
8.4.1
8.4.2
8.4.3
9.
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Cool Roofs
Green Roofs
Sustainable Building
SOLID WASTE MANAGEMENT PLAN
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10.
TRAFFIC IMPACT ANALYSIS
10.1
10.2
Increases in Vehicular Traffic

Traffic and Transportation Management Plan
11.
SECURITY AND EVACUATION PLAN
11.1
11.2
Security
Emergency and Fire-Fighting Protocols
11.2.1
11.2.2
11.2.3
11.2.4
138
144
Fire-fighting Regimes
Fire Drills
Evacuation Plan
Other Emergencies
12.
ENVIRONMENTAL MONITORING
12.1
Environmental Testing
12.1.1
12.1.2
12.1.3
12.1.4
12.1.5
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Soil
Water Quality
Traffic Congestion
Noise
Conclusions of Environmental Monitoring
12.2
12.3
Environmental Monitoring During Project Execution

Post-Project Monitoring
13.
SOCIAL IMPACT ASSESSMENT
13.1
Public Consultation
153
13.1.1 Identification of Stakeholders

13.1.2 Consultation Process
13.2
Social Impact Assessment and Survey

13.2.1
13.2.2
13.2.3
13.2.4
13.2.5
Social Survey Methodology

Conclusions of the Social Survey
Mitigating Factors
Employment Generation
Complaint Redressal Mechanism During Construction
13.3
Measures for Surrounding Areas
14.
COMPENSATION AND RESETTLEMENT
14.1
14.2
Compensation
Resettlement Plan
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14.3
Grievance Redressal Mechanism
15.
CONCLUSIONS
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ENDNOTES
168
REFERENCES
171
APPENDICES (Volume II)
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DISCLAIMER
This Environmental Impact Assessment has been prepared after consultation

and interviews with the proponents and designers of the project, reference to laws,
rules and regulations, visits to the project site, consultation with all stakeholders,
including neighbours, and samples collected at the project site and from nearby
areas. Any error(s) found in the report is the sole responsibility of the consultants
preparing this report, Bizcorp Consultants,
and not the proponents of the proposed project.
Volume I of this report comprises a total of 169 numbered pages,

excluding title pages, contents, disclaimer, sundry tables and chapter separators.
Volume II contains twenty-two appendices.
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1.
EXECUTIVE SUMMARY
The Workers Welfare Fund (WWF), proponents of the project being

reviewed through this Environmental Impact Assessment, are
constructing a two hundred bed surgical hospital on Sukkur Bypass,
Sukkur, through a turnkey project. The present project is a part of WWFs
development schemes for the welfare of workers and shall provide stateof-the-art medical facilities, especially for workers and their families. The
project shall comply with national and international guidelines pertaining
to environmental protection policies as well as applicable laws, rules and
regulations.
1.1
PROJECT DESCRIPTION
The reviewed project involves construction of a modern surgical hospital

at Sukkur on Sukkur Bypass. Area allocated for the project is 217,815
square feet, while total covered area of the eight-floor hospital building,
including ground floor and basement, shall be 248,360 square feet. Total
cost of the project is estimated to be Rs. 2.7 billion, with completion
period of approximately two years. Brick and mortar component of the
cost shall be about Rs. 560.777 million, excluding building systems and
external development works, whereas the remaining cost shall comprise
furnishing, equipment, software and consultancy.
1.2
PHYSICAL AND BIOLOGICAL ENVIRONMENTS
The project area is largely rural but being rapidly urbanised on account of
proximity to Sukkur Airport and a wide inter-city road. Soil at the
proposed site does not contain any physical or chemical hazards that can
cause serious concerns for designing and construction of foundation
structures. Sukkur District has arid climate with a short mild winter
commencing from the middle of October, a hot summer from mid-March
to mid-October and sporadic rains in July and August during the
monsoon. Groundwater is mostly free of infirmities and is fit for direct
human consumption, irrigation and construction. There are some small
pockets of brackish water in the district, away from the river and
irrigation canals. The project site open and is available for developmental
activities. River Indus flows mainly to the south of the project site at a
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distance of about two kilometres, while Daddo Canal is immediately to

the north across the road. Area immediately towards the east is under
cultivation whereas pockets towards the west are being developed for
housing, mainly apartment blocks.
1.3
SOCIO-ECONOMIC ENVIRONMENT
Construction of the hospital next to the future site of Ghulam Mohammad

Mahr Medical College, Sukkur, will not only greatly facilitate teaching
facilities at that institution but also provide medical facilities at a location
on an inter-city highway that can be easily access from nearby towns and
cities, as well as through air connection from Sukkur Airport, which is
hardly a few kilometres away. Chapter Six of this report discusses
physical and socio-economic environment of the project area.
1.4
An application along with this Environmental Impact Assessment is to be

submitted by the proponents to the Sindh Environmental Protection
Agency to obtain Environmental Approval for the project in compliance
of the relevant law. This report highlights environmental, social, physical
and other aspects of the project both during construction and operation
and provides measures necessary to mitigate environmental impact on the
local environment. It also contains supplementary information deemed
necessary under the guidelines prescribed by the government for
preparing an environmental study to assist the Environmental Protection
Agency in evaluating environmental impact of the project and whether it
in any way impinges on the local environment.
1.5
ENVIRONMENTAL CONCERNS
There are several concerns related to the reviewed project, which shall be
suitably addressed during project implementation, considering that it has
not yet been launched. Due to the nature of the project, most of the
environmental concerns shall be limited to the implementation stage and
not during operation. These are as under:
Population Displacement: The previous site selected in the
city would have resulted in displacement of twenty-four
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households presently residing at that site in quarters that were to

be demolished to clear the area for project implementation.
Rejection of that site and relocation at the present site which is
open and readily available has thus avoided a social impact of
the project. Mitigation: Selection of the alternate site has
eliminated a negative social impact of the project in total;
Removal of Vegetation: As compared to the previous site,
there is no vegetation which would need to be cleared during
site development. Mitigation: An amount of Rs. 2.632 million
have been set aside in the project cost estimates for horticulture
at the project site, which shall provide for planting of two
hundred and ten trees and shrubs and at least five hundred floral
plants, aromatic flowers etc.;
Earthworks: A basement is envisaged in the project design,
which shall involve removal of about 315,000 cubic feet of
earth during pitting. Mitigation: Most of the excavated earth
shall be reused at the site for backfilling, levelling of
surrounding, building of ornamental mounds etc., whereas
excess earth, if any, shall be carried away for disposal in an
environmental-friendly manner;
Construction Impact: Construction impacts of the proposed
project could include noise, dust emissions, possible soil
contamination, solid and liquid waste from construction
activities, construction camp effluent, if any, vehicular traffic,
and smoke emissions and exhausts from vehicles, machinery
and equipment. Mitigation: Most of the construction phase
environmental impacts shall be mitigated by developing a sound
construction management plan. Special attention shall be paid to
prevention of dust dispersal through erection of windshields and
continuous sprinkling of the ground so as to ensure that there is
no dust dispersal. An Environmental Management Plan for the
construction phase is appended to the report and environmentfriendly construction techniques shall alleviate negative
externalities of construction activities;
Wastewater Generation and Disposal: A large measure of
wastewater shall result from construction activities as also
during operation of the project. Mitigation: Measures for
wastewater disposal shall include conservation of water,
minimisation of liquid waste, sieving of liquid waste, and
release into the nearest sewerage drain, which runs to the west
of the project site. A small wastewater treatment plant, which
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shall become functional prior to project operation, is also

embedded in the project design;
Solid Waste: Solid waste shall be generated both during project
implementation and operation. Construction waste will include
removed vegetation, excess construction materials, construction
waste and excavated material. Inappropriate disposal, apart
from creating pollution of water and soil, also lowers general
aesthetic values of the local environment. Disposal of medical
waste during operation of the hospital shall be a primary
concern. Mitigation: An incinerator shall be installed at the
project site for disposal of medical waste. A waste management
plan, following best possible environmental practices, has been
developed for disposal of all forms of waste. This includes
keeping records of solid waste generated at the site, segregation
of waste, maximising recycling and reuse, storage and handling
of hazardous materials, if any, in accordance with hazard
characteristics, disposal at municipal garbage disposal site, and
regular waste audits;
Hazardous Waste: Hazardous and medical waste shall be a
major cause for concern during project operation. Mitigation:
All hazardous waste shall be disposed strictly in accordance
with the Hazardous Substances Rules, 2003, and Hospital
Waste management Rules, 2005. A solid waste management
plan has been appended to this report which indicates the
volume of construction and operational waste that shall be
generated;
Socio-economic Impact: Construction of the hospital shall in
no way impact adversely on socio-economic conditions
prevailing in the project area. Operation of the project shall not
have any adverse impact but shall rather enhance availability of
medical facilities in the project area. Mitigation: Construction
activities shall result in direct generation of employment
opportunities for at least two hundred skilled and unskilled
workers, and business opportunities for suppliers of
construction products. Similarly, operation of the project shall
create as many as six hundred and five permanent positions for
medical staff and skilled workers. Construction of the state-ofthe-art hospital shall enhance medical facilities for workers in
and around the project area;
Shadow: Shadows from structures, particularly in urban and
semi-urban areas, can have an adverse impact on the local
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environment, resulting in loss of sunshine and thereby

impacting adversely on agricultural productivity and loss of
light and energy for structures upon which the shadow falls,
resulting in higher heating costs for affected households.
Mitigation: Shadows cast by the hospital building shall fall
entirely within the compound and there shall thus be no impact
from shadows on adjoining properties, and
Visual Intrusion Physical presence of tall buildings can have
some impact on aesthetics value of a project area by marring the
skyline and can also sometimes obstruct a scenic view.
Mitigation: There are no visual resources in the project area
that can be lost or impacted upon as a result of construction of
the eight-floor building. In any case, there are no private
properties close to the project site. Most significantly, the
elegant elevation of the proposed structure shall in fact enrich
the aesthetics of the project area.
Additional steps that shall be taken to prevent, correct or mitigate some of
the adverse impacts described briefly heretofore are discussed in detail in
subsequent chapters and sections of this report.
1.6
POSITIVE IMPACTS
Despite environmental concerns indicated in the preceding section of this

Executive Summary, the project shall have some major positive impacts
as described in latter parts of this report and can be summarised as
follows:
A two hundred bed modern surgical hospital shall add to the
existing pool of medical facilities in and around the area;
The proposed project shall cater especially for exclusive
medical facilities for registered industrial and commercial
workers and their families;
Equipment to be installed shall correspond to the latest
international quality control standards, thereby providing the
best medical attention in the project area;
The project cost of Rs. 2.7 billion during construction, and
annual operating costs of Rs. 75.76 million on establishment
and Rs. 160.35 million on operations and maintenance shall
lead to economic opportunities for local businesses;
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The project under review will result in creation of at least two

hundred temporary and six hundred and five permanent
employment opportunities for skilled and unskilled workers,
and
Almost the entire unskilled labour force, and some skilled
workers, shall hail from the project area, thus benefitting the
local population directly.
1.7
ENVIRONMENTAL AND SOCIAL COSTS
An assessment of the social impact is given in Chapter 13, which shows

that there shall not be any environmental and social costs of the project.
1.8
COMPENSATION AND RESETTLEMENT
A Land Acquisition and Resettlement Plan associated with a project

provides the basis for mitigation of its socio-economic impacts.
Legislation covering procedures for land acquisition and compensation
thereof is contained in the Land Acquisition Act, 1894, and in the Project
Implementation and Resettlement of Affected Persons Ordinance, 2001.
There are no compensation and resettlement issues associated with the
proposed project.
1.9
ENVIRONMENTAL MANAGEMENT AND MONITORING
While carrying out Environmental Screening of the proposed project, this

study also suggests an Environmental Management Plan and an
Environmental Monitoring Programme, both of which must be
implemented by the proponents in order to ensure that project activities
do not impact on the environment beyond reasonable and acceptable
limits. Environmental monitoring costs for the proponents are expected to
be Rs. 780,000.
1.10 CONCLUSIONS
Based on findings of this environmental study, it has been assessed that

there will be insignificant environmental damage to the local land, water
and biological resources and that residual impacts of the project shall be
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within acceptable limits provided it is undertaken as recommended in this

study, and mitigation measures are adopted as advised. Residual impacts
shall only be to the extent of medical waste, traffic congestion, and noise.
This study has been conducted after consultation and interviews with the
proponents, reference to laws, rules and regulations, visits to the project
site, discussions with all stakeholders including local residents,
environmental testing for water and noise, and guidance from
environmental agencies. Error(s) found in the report is the sole
responsibility of the consultants preparing this report, Bizcorp, and not
the proponents of the project.
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INTRODUCTION
WWF intends to construct a surgical hospital on Sukkur Bypass to

provide modern medical facilities, especially for workers and their
families. After completion, the project shall be taken over for operation
by the Workers Welfare Board, Sindh, a subordinate autonomous wing
of Labour Department, Government of Sindh, which is funded entirely by
the proponents.
2.1
PROJECT LOCATION
The project is to be implemented within an open site on Sukkur Bypass

that has been earmarked for Ghulam Muhammad Mahar Medical College,
Sukkur. A map of the project area, indicating the project site, is placed at
Appendix I. Appendix II are satellite images of the proposed site and
project area, while transparencies of the immediate project area are at
Appendix III.
2.2
OBJECTIVES OF THE PROJECT
There are an estimated two hundred thousand registered and unregistered

industrial and commercial workers in and around the project area who
face an acute shortage of healthcare facilities. Accordingly, the project
aims to provide modern medical facilities for workers and their families.
The proposed hospital shall have the following features:
Ten-bed burn unit, along with a Trauma Centre;

Twenty-bed Intensive Care Unit;
Thirty-bed General Surgery Unit;
Ten-bed Neurosurgery Unit;
Ten-bed ENT Unit;
Ten-bed Eye Unit;
Sixty-bed Orthopaedic Unit;
Ten-bed Urology Unit;
Sixty-bed Gynaecology Unit;
Thirty-bed General Surgery Unit for female patients;
Emergency and OPD;
Operation theatres;
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Biomedical/clinical engineering;
Allied medical facilities;
Laboratories, diagnostic services, support services for burn
cases, blood banks, and pharmacy, and
Mortuary.
On the administrative and support side, the hospital shall have the
following main facilities:
Maintenance of complete and permanent medical records;
Administration, finance, human resources, public relations and
marketing security, and procurement;
Information technology, quality assurance, engineering and
maintenance, and waste disposal;
Patient transport services/ambulances;
Food services;
Housekeeping, laundry and linen, and
Training and research and development.
2.3
SCOPE OF WORK
Development works at the site will be undertaken by a construction firm

to be selected after a process of prequalification and open competitive
bidding in consonance with federal government procedures, regulations
and guidelines. Primary development works shall comprise land clearing
and levelling, pitting of the project site for piling and construction of the
basement, and construction of approach paths. The designers of the
project anticipate a minimum two- year period for completion of the
project after commencement of construction. Total cost of the reviewed
project is an estimated Rs. 2.70 billion, with a construction component of
Rs. 1.05 billion, excluding consultancy costs of Rs. 108.265 million.
Expenditures on furnishing, equipment and software shall be about Rs.
1.42 billion.
2.4
PROJECT PROPONENTS
The proponents of the project are the Workers Welfare Fund (WWF), a
regulatory authority established in 1970 under the Workers Welfare
Ordinance, 1970, to prepare and oversee projects for welfare of workers.
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WWF works under the direct supervision of the Human Resource and
Development Division, Government of Pakistan, Islamabad, and has a
tripartite decision-making body comprising representatives of workers,
employers and government. The sources of income of the WWF are
undistributed profits of industrial units under the Companies Profit
(Workers Participation) Act, 1968, and a sum equal to two percent of
total income of industrial establishments that have minimum income of
Rs. 0.5 million in a tax year. Workers Welfare Boards have been
established in the four provinces, and for specific purposes, which
implement various projects approved and funded by the WWF.
2.5
PROJECT DESIGNERS/CONSULTANTS
The project has been designed by Langdon Wilson International (LWI), a

multi-discipline international consultancy firm with headquarters in Los
Angeles, United States of America. The project designers/consultants
were appointed after floating of international tenders and a prequalification process. LWI operates at three locations within the United
States of America with international offices in Kuwait, Qatar and the
Peoples Republic of China. LWIs Healthcare Planning & Design
Division includes specialists in site and land-use planning, facility
planning, space programming, architectural design, interior design,
medical equipment planning, economics, life-cycle cost analysis,
operational analysis, code and life safety analysis, computerised
construction cost management and cost-estimation. LWI has completed
over one hundred medical projects, involving both new construction and
renovation of existing facilities.
LWI has since the 1960s rendered consultancy services to healthcare
practitioners and designed major hospitals for the largest healthcare
organisations in the United States as well as across the world. Major
projects undertaken by LWI include King/Drew Medical Centre, Trauma
Care and Diagnostic Treatment Centre, Cedars-Sinai North Critical Care
Tower, Los Angeles (238 ICU beds), Jaber Al Ahmed Hospital, Kuwait
(1,200 bed medical city), New Ahmadi Hospital, Kuwait (200 bed
hospital), Cardiac Centre, Kuwait (addition of 150 beds), Al Maidan
Maternity Hospital, Kuwait (180 bed hospital), Princess Haya Hospital,
Jordan (300 bed acute care hospital), H.H. Khalifa Hospital, High Desert
Hospital, Lancaster, Olive View Medical Centre/Emergency Expansion,
Sylmar, Medical Planning for Department of Health, Los Angeles
County, and planning study for Los Angeles Country harbour/UCLA
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Medical Centre. Additional responsibilities of LWI in connection with the

proposed project include preparation of tender documents, advice to the
proponents on prequalification of construction contractors, evaluation of
bids, providing top supervision during project implementation,
procurement of equipment, and engagement of other consultants, if
necessary. Further details about the project designers/consultants are
available at their website.1
2.6
CONSTRUCTION CONTRACTOR
The proponents shall appoint an experienced construction company to

implement the project to be selected after a prequalification and tendering
process under the supervision of the project consultants. It shall be
ensured that the contract is appointed to an entity with established
credentials. The contractor shall be bound by the proponents to ensure
that the project is executed in an environment-friendly manner and that
all environmental and occupational health and safety health laws are
observed.
2.7
ENVIRONMENTAL CONSULTANTS
The services of Bizcorp have been engaged by the project consultants to

carry out an Environmental Impact Assessment of the proposed project.
This study has been conducted in line with the regulatory framework and
guidelines prescribed by the federal government for conducting
environmental studies. The consultants render management and technical
services to varied clients in government and industry. This study has been
completed using a common template for construction projects, through a
qualified team drawn from various disciplines so as to cover all aspects of
the assignment.
2.8
PROJECT JUSTIFICATION
A large number of workers have reported at the Civil Hospital, Sukkur,

during the last three years for medical attention, and a significant number
of these patients required burn treatment and trauma counselling.
Mortality rate for such cases was on the high side. Considering the
severity of this condition and to prevent loss of life, there is a need to
provide modern health facilities in the city and to cater for medical needs
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especially of workers of the project area. Further, in view of the high risk
of loss of life, it is imperative to apply international standards of
provision of healthcare facilities and consequently reduce the rates of
mortality, deformity, disability and post-traumatic stress disorders
associated with such cases.
2.9
CONTACT PERSONS
As required under the Guidelines for Preparation and Review of

Environmental Report, November 1997, contact persons for the
proponents and consultants carrying out this Environmental Impact
Assessment are indicated in the following table:
TABLE 1: CONTACT PERSONS
Proponents
Consultant
Mr. Afzal Hameed, Director,

Workers Welfare Fund,
F-6 Markaz, Islamabad
Telephone: 051-920 4374
Facsimile: 051-922 1323
Website: www.molm.gov.pk
Mr. Anjum-ud-din Ahmed,

Bizcorp, House No. 94, Street No. 66, F11/4, Islamabad
Telephone: 051-221 2829, Facsimile: 051282 1109
E-mail: bizcorp.pk@gmail.com
2.10 DOCUMENT STRUCTURE
Chapter 1 is an Executive Summary of the report. Chapter 2 provides an

introduction to the project and justification for the project. Chapter 3
describes the approach and methodology of the environmental study.
Chapter 4 discusses legislative and regulatory framework and the
institutional setup in the country relevant to environment and
environmental assessment. Chapter 5 provides a detailed description of
the project and its components. Baseline environmental conditions are
presented in Chapter 6, whereas Chapter 7 presents an environmental
impact assessment. Chapter 8 discusses environmental management
whereas the Solid Waste Management Programme is presented in
Chapter 9. Chapter 10 is a Traffic Impact Analysis, Chapter 11 contains
the Security and Evacuation Plan and Chapter 12 deals with
environmental monitoring. Chapter 13 contains the Social Impact
Assessment, Chapter 14 describes issues relating to compensation and
resettlement and the conclusions are contained in Chapter 15, followed by
twenty-two appendices to the study.
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APPROACH AND METHODOLOGY
Section 12 of the Pakistan Environmental Protection Act, 1997 requires

the proponents of every development project in the country to conduct
either an Initial Environmental Examination or an Environmental Impact
Assessment where the proposed initiative is likely to cause an adverse
environmental effect. This Environmental Impact Assessment will be
submitted to obtain Environmental Approval for the proposed project.
3.1
AIMS AND OBJECTIVES

OF THE ENVIRONMENTAL IMPACT ASSESSMENT
This report serves two purposes. Firstly, it provides necessary

information to the Sindh Environmental Protection Agency to determine
whether the project poses any environmental threat. Secondly, it shall
serve as a ready-reckoner for the proponents to manage the project during
operation in an environment-friendly manner and abide especially by
recommendations of the Environmental Management Plan and implement
an Environmental Monitoring Programme. The main aims and objectives
of this environmental study are summarised as follows.
Identification and assessment of all environmental impacts or
social sensitivity, whether major or minor, that might be caused
during site development, construction and project operation in
order to formulate an effective Environmental Management
Plan and Environmental Monitoring Programme;
Suggest measures required to mitigate adverse environmental
impact through minimisation, elimination, reversal or
compensation of such probable impacts;
Pinpoint and assess all possible impacts of project operation on
the natural, physical, biological and socio-economic
environment of the area and evaluate these both qualitatively
and quantitatively, wherever possible, and determine their
significance in light of the technical and regulatory concerns,
and public perceptions, and
Prepare an environmental report presenting recommendations
for effective implementation of the project in a manner that it
does not compromise the environment existing at the project
site.
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In order to achieve the aforesaid objectives, the study has been mainly
divided into the following sub-tasks:
Identification of various legal and statuary requirements as set
forth by the Pakistan Environmental Protection Act, 1997,
guidelines for preparation of environmental studies and review
of existing regulatory and administrative framework in the
country with reference to development projects of similar
nature;
Collection and scrutiny of data related to physical, ecological and
socio-economic aspects of the project site and surrounding areas;
Identification and evaluation of salient environmental impacts
from activities to be carried out during construction;
Identification of mitigation measures required to minimise
negative externalities of the project, and
Preparation of an Environmental Management Plan and
proposing a mechanism for environmental monitoring during
operation of the project.
The environmental study is a tool to delineate all possible adverse
environmental impacts that might result from a project and to measure
their severity and the risks associated. Mitigation measures are thereafter
evolved for impacts that have minor or moderate adverse fallout.
Identification of an adverse impact is the cornerstone of the assessment
matrix and its efficacy depends largely on professional expertise of the
team of specialists carrying out the environmental examination in line
with national and international guidelines. The significance of all adverse
impacts is thereafter evaluated in terms of severity and possibility of
occurring. Impact evaluation prioritises each potential impact and filters
out those insignificant or of no consequence. Significance of impacts is
then juxtaposed with likely effects on the natural eco-system, levels of
public concern and conformity with legislative or statutory obligations.
Assessment of severity takes into account the nature, magnitude, extent
and location, timing and duration, and reversibility of potential impacts.
Characterisation of significant impacts provides the basis to formulate
measures for mitigation and monitoring. During this environmental study,
all impacts were identified and examined on the basis of field data,
secondary data, expert opinion, and findings of other similar studies.
Primary data was collected through field visits and included a description
of the present environment in the project area, environmental testing for
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noise and water, traffic counts, social survey, transparencies of the project
site, and information collected from the project proponents.
Impact identification and classification of impacts is a precursor to
framing appropriate mitigation measures, which include practices,
technologies or activities that avert, reduce, reverse or compensate for
such impacts. Finally, the Environmental Management Plan provides for
effective implementation of mitigation measures. The Environmental
Management Plan features controls to minimise identified impacts, and
suggests a monitoring regime in the form of the Environmental
Monitoring Programme to study residual impacts, if any, during operation
of the project. It prescribes procedures to be followed and identifies roles
and responsibilities during operation, including post-project reporting.
3.2
SCOPE OF THE STUDY
Laws, rules, regulations and guidelines issued by the federal government

and local laws and policies considered while formulating this report
include:
Environmental Protection Agency Review of Initial
Environmental Examination and Environmental Impact
Assessment Regulations, 2000;
Pakistan Environmental Protection Act, 1997
Policy and procedures for the filing, review and approval of
environmental studies by the concerned Environmental
Protection Agency of the federal or provincial government;
Guidelines for preparation and review of environmental reports;
Guidelines for public participation;
Guidelines for environmental assessment of construction
projects;
Guidelines for sensitive and critical areas;
Hospital Waste Management Rules, 2005, and
Relevant federal and provincial laws, rules and regulations
relating to the project.
This environmental study assesses environmental, social, physical and
other aspects of the project, both during construction and operation, and
identifies measures necessary to be adopted to mitigate any
environmental impact on any segment of the surrounding environment.
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This study has specifically followed, to the extent possible, format laid
down under Serial 2.3 of the Guidelines for the Preparation and Review
of Environmental Report circulated in November 1997, and related
instructions covering environmental reports.1
3.3
STUDY METHODOLOGY
Key steps followed while conducting the environmental study were

screening, scoping, data collection and compilation, environmental
screening and impact assessment, documentation and consultation. The
screening process comprised compilation and review of information on
the project. Most of this information was obtained from the project
proponents and added to data on relevant legislation, regulations,
guidelines and standards. Scoping involved a review of collected
information and identification of potential environmental issues. A
scoping matrix of the project under review is placed overleaf. Data
gathering centred on collection and compilation of environmental data to
develop an environmental baseline of the project area. Review of
secondary sources as well as primary and field data was also carried out.
Environmental screening and impact assessment process, discussed in
Chapter Seven, determined potential impacts of the proposed project
through examination and testing of environmental, socio-economic, and
project information gathered by the study team. Subsequently, potential
impacts were characterised in order to analyse their significance.
Mitigation measures were identified where required to minimise
environmental impacts.
A management framework was also developed in the form of an
Environmental Management Plan for implementation of identified
mitigation measures. Consultation with the project proponents and other
stakeholders, such as local residents and persons that might be affected by
the project as also various government departments, was carried out at the
same time essentially to establish public concerns about the project and
pinpoint any aspect that may have been overlooked during preparatory
work. Documentation was the last step of the study, which comprised
collation of data and preparation of the report along with requisite
appendices in proof of the study and its findings. Accordingly, this report
includes a brief description of the project, an overview of environmental
legislation relevant to the project, a description of baseline environmental
and socio-economic conditions in the project area, and potential project
impacts and mitigation measures.
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3.3.1 Inception Procedures
The environmental study commenced on February 1, 2011, after notice to

proceed was received to commence work. In order to complete the study
within the time-span desired by the proponents, a qualified team was
assembled to undertake the study and specific assignments were entrusted
to each member of the team, each of whom were armed with the
resources, tasks, instructions and checklists to carry out nominated tasks
within the specified time-period. The study had to be redone when the
initial project site within the premises of Civil Hospital, Sukkur, was
abandoned and a new site was selected on Sukkur Bypass.
3.3.2 Document Resources
The purpose of discussions with the proponents included collection of

documentation and compile background information on the project. The
reliability of an environmental study depends heavily on authenticity and
depth of baseline information, which has to be used to assess possible
impacts of a project on existing environment. Environmental conditions
and trends relating to the project area were examined with the help of
published secondary data on aspects relating to physical conditions,
biological resources, human and economic development and heritage
aspects. These are described briefly as follows:
Physical Conditions: Topography, geology, soils, surface and
groundwater resources and climate;
Biological Resources: Flora and fauna, particularly in respect
of rare or endangered species, protected areas or other areas of
significant environmental importance;
Human and Economic Development: Settlements, socioeconomic conditions, infrastructure and land use, and
Heritage Aspects: Site of cultural, archaeological or historical
significance.
Discussions were also carried out with residents of the project area and in
particular people that may be affected by the project to draw information
about the area and views and concerns of local inhabitants and businesses
about impending project activities. Findings of the social survey are given
in a subsequent section. The study team then collated information on
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official policies, legislation, rules and regulations covering all aspects of

the proposed project to ensure that the document is prepared within the
regulatory framework. A list of relevant policies, laws, rules and
regulations was prepared for inclusion in the report.
3.4
REPORTING
Environmental reports prepared to assess environmental impact of a

project are designed to assist:
The proponents, to plan, design and implement the project
proposal in a manner that eliminates or minimises any negative
impact on the biophysical and socio-economic environments
and maximises the benefits to all parties in the most costeffective manner. An environmental study is meant not only to
assist the Environmental Protection Agency in considering
award of environmental approval for a particular project but
also supposed to make a proponent aware of all environmental
aspects of the project and the environmental framework within
which the project is examined through an Environmental Impact
Assessment. Thus, whereas much of the contents of an
environmental study may be routine for the agency assessing
the project, they act at the same time as a guidebook for a
proponent that might not be aware of any segment of the
environmental gamut;
The Environmental Protection Agency, to decide whether a
project proposal should be approved and if so, what terms and
conditions should be attached to such approval, and
The general public, to understand the project proposal and
learn how it can impact on the local community and the
environment, whether positively or adversely. Accordingly,
copies of an Environmental Impact Assessment are placed at
prominent places by the concerned Environmental Protection
Agency for unrestricted and easy public access.
The study has been conducted using prescribed methodology and covers
the following essential aspects relating to the project under review:
Introduction, including the methodology for preparing the
environmental report;
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Legal and administrative framework governing environmental

impact of projects;
Description of the project and background environmental
conditions in the area;
Screening of potential environmental impacts;
Evaluation of the significance of environmental impacts;
Recommended mitigation measures;
Environmental Management Plan, Environmental Monitoring
Programme and institutional requirements;
Social Impact Assessment and compensation issues, and
Conclusions, indicating positive and possible adverse impacts
of the project.
An essential part of the reporting process is enforcement of the
Environmental Management Plan and post-project monitoring, since
merely grant of approval for a project does not absolve the proponents of
future responsibilities. During project operation, proponents have to abide
by restrictions and instructions contained in the environmental approval
and keep the environmental agency concerned informed of all measures
taken in the context of environmental monitoring. The proponents shall
frame an environmental monitoring system with a charter of duties as
also with resources necessary to carry out environmental monitoring and
implementation of the proposed Environmental Management Plan. The
proponents shall take appropriate measures in this behalf after
environmental approval is issued by Sindh Environmental Protection
Agency. A proposal for environmental monitoring during project
operation has been included as a recommendation for the proponents so
that the monitoring mechanism can be activated to comply with
mandatory provisions of the law and pre-conditions of environmental
approval. Environmental management after the project has been
completed and comes into operation is a part of the reporting process and
has been appropriately addressed within the Environmental Management
Plan added in Chapter 8.
3.5
CENSUS SURVEY OF AFFECTED PERSONS
The project can affect certain existing natural and man-made features
within the project area. Data was collected to cover all such features. The
first step towards assessment of the social and financial impact of a
project is to identify and list all stakeholders that can be directly or
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indirectly affected by the project. A census is thereafter carried out to

identify the number of such persons or institutions, nature of their
interests, type and value of assets, replacement costs of such assets, and
social vulnerabilities. There are no such affected persons in respect of the
project under review.
3.6
RESETTLEMENT ISSUES
Public consultation provides the basis for an examination of resettlement

issues, which are not relevant in respect of the selected site.
3.7
PUBLIC CONSULTATION
The object of identification of stakeholders and the affected persons was

basically to pave the ground for public consultation in order to enlist
views of all concerned about the project.
3.8
ASSESSMENT OF
ENVIRONMENTAL AND SOCIAL IMPACTS
A socio-economic survey was carried out to gather data about the

demographic characteristics of the project area, education and literacy,
nature of businesses and vocations, income and expenditure patterns,
value of assets, housing patterns, availability of civic amenities and
possible impact of the project under review on all such parameters. While
assessing the environmental and social impacts of the project, the factors
considered included firstly, the nature, magnitude or degree of the impact;
secondly, the extent of impact on development work; thirdly, time,
duration and frequency of the impact; fourthly, probability of occurrence
of the impact and, finally, importance or the sensitivity of impact.
3.9
CONSULTATION WITH THE PROPONENTS
Members of the study team, and the project coordinator, met the project
consultants and concerned officers of the WWF dealing with the
proposed project and held discussions to gather information about WWF
and the background, planning, construction and operational stages of the
proposed project.
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3.10 CONSULTATION WITH EPA
One of the basic requirements in preparation of an environmental report

is that it should be up-to-date and it must keep abreast of all
developments. This is achieved by remaining current on all
environmental issues and by maintaining constant contact with the
concerned regulatory authorities. Accordingly, the environmental
consultants continue to liaise with environmental agencies so as to ensure
that the study incorporates all innovations and developments.
3.11 FIELD VISITS
Field visits are an integral part of an environmental study and must be

undertaken to prepare a precise perspective of the project. The following
table shows dates of field visits to project site, including site visits and
consultation carried out earlier in the context of the previous site of the
project within the premises of Civil Hospital that remain relevant.
TABLE 3: FIELD VISITS
Sr.
No. Date(s):
February 1-22
and August 191 20, 2011
February 7-9,
2 2011
August 21-24,
3 2011
February 14-28
and August 214 24, 2011
February 18-26
and August 185 20, 2011
6 August 21, 2011
7
8
9
10
21
August 21, 2011

August 21, 2011
September 9
February 24-28,
August 21-24,
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Bizcorp Consultants
Purpose:
Interviews with the project
consultants at Lahore
Interviews with the project
proponents at Islamabad
Visited by:
Project Coordinator
Site inspections
Environmentalist
Study Team/
Researchers (Env.)
Collection of primary data and

public consultation
Researchers (Env.)
Meetings with various

government departments
Photography of the project site
Environmental testing for
noise
Traffic surveys
Collection of water sample
Social survey
Researchers (Env.)
Researchers (Env.)
Researchers (Env.)
Researchers
Researchers (Env.)
Researchers
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3.12 STUDY TEAM
A team of experience professionals drawn from various disciplines and

having relevant experience of conducting environmental and social
assessments participates in the preparation of an environmental report.
This Environmental Impact Assessment has been prepared by the
following core team:
TABLE 4: ENVIRONMENTAL STUDY TEAM
Mrs. Talat Fayyaz Mansoor
EIA Specialist /Team Leader
Ms. Ambareen Tariq Khan
Environmentalist*
M/s Mycon
Civil Engineers
Mr. Mazhar Shamim

Ms. Ayesha Basharat
Mr. Zafar Mirza
Electrical Engineer (Power Generation)

Economist (traffic, transportation aspects, social
surveys)
Mechanical Engineer
Mr. Abdul Qayyum

Mr. Khurram Shehzad
Mr. Aslam Janjua
Mr. Ameer Ali Burq
Mr. Anjum-ud-din Ahmed
Researcher (Environmentalist)
Researcher (Environmentalist)
Land Revenue and Land Acquisition Expert
Management Specialist/Report Writer
Project Coordinator
* Not involved with the environmental study of the new site
The team indicated above was complemented by researchers recruited

locally, comprising students from educational institutions, who carried
out social surveys and traffic counts and interacted with the local
population. Being locals, these researchers had the benefit of knowledge
of all social values, customs and traditions of the project area. The study
team, along with researchers recruited locally, collaborated during a
comprehensive survey of project site, discussions with the proponents and
stakeholders, collection and analysis of data, conducting surveys and spot
analyses, and preparation of the report in consultation with the specialists.
Services of other experts were also availed on need basis and a researcher
compiled secondary physical and socio-economic data of the project area.
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REGULATORY FRAMEWORK
This chapter discusses the legislative and regulatory framework and

institutional set-up existing currently in the country, relevant to
environment and environmental assessment, along with environmental
guidelines issued by the federal government.
4.1
CONSTITUTIONAL PROVISION
The Constitution of Pakistan vests legislative powers with the National

Assembly and the Senate at the federal level and with provincial
assemblies in the provinces. Environmental pollution and ecology is an
exclusively provincial subject subsequent to the Eighteenth Amendment
to the Constitution. In conjunction with Article 9 of the Constitution,
which states that No person shall be deprived of life or liberty, save in
accordance with law, the Supreme Court of Pakistan has declared that
the right to a clean environment is a fundamental constitutional right to
life.1
4.2
POLICY FRAMEWORK
The National Environment Policy of 2005 provides an overarching

framework to address environmental issues framed by the country,
especially fresh water bodies and coastal waters, air pollution, lack of
proper waste management, deforestation, loss of biodiversity,
desertification, natural disasters and climate change.2 The policy also sets
directives to resolve cross-sectoral problems too as well as underlying
causes of environmental degradation and meeting international
obligations. The policy aims to protect, conserve and restore Pakistans
environment so as to improve quality of life through sustainable
development and its objectives are:
Conservation, restoration and efficient management of
environmental resources;
Integration of environmental considerations in policy
formulation and planning processes;
Capacity building of public-sector agencies and other
stakeholders to manage environment more efficiently;
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Meeting international obligations effectively in line with

national aspirations, and
Creating a demand for environment through mass awareness
and mobilisation of the community.
Paragraph 5.1 of the National Environment Policy stipulates that the
provisions of the Pakistan Environmental Protection Act, 1997, relating
to environmental impact assessment must be diligently enforced in
respect of public sector development projects. Public sector organisations,
such as WWF, have thus been specifically directed to take suitable
measures for preservation of the environment during execution of public
sector development projects.
The National Conservation Strategy was the primary policy pledging to
balance Pakistans economic development with conservation of natural
resources.1 The Strategy was put together following a nine-year
consultative process with all stakeholders, including government
organisations,
environmental
experts,
interested
individuals,
communities, non-governmental organisations and multilateral and
bilateral agencies. The Strategy was approved at the level of the Federal
Cabinet in 1992 as the principal policy document for the countrys
environmental management. The underlying goal of this document is that
all economic and statutory development in the country should be such
that it does not conflict with the interests of conservation of nature. The
three overriding objectives of the National Conservation Strategy are:
Conservation of natural resources;
Sustainable development, and
Improved efficiency in the use and management of resources.
These three objectives are to be achieved through greater public
participation in development and environmental management,
development of an environment-economic development nexus and lasting
improvements in quality of life. The Strategy proposes policies in
fourteen primary, secondary and tertiary sectors, which are agriculture,
forest management, rangeland rehabilitation, livestock management,
water resources, wildlife, mineral resources, marine and coastal resource
management, fisheries, industrial development, tourism, human
settlement, pollution control and energy. Policies relating only to the last
two sectors are related to the project under review and that too only
marginally. The policies for these sectors centre on the following:
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Pollution Control: Promotion of solid waste disposal and

wastewater treatment technologies that provide for solid waste
recycling, recovery and reuse of water, nutrients and organic
matter, and
Energy: Usage of energy resources efficiently and propagation
of energy conservation.
Pakistan is a signatory to the Convention on Biological Diversity, and is
thereby obligated to develop a national strategy for conservation of
biodiversity. Accordingly, the federal government has constituted a
Biodiversity Working Group under the auspices of the Ministry of
Environment to develop a Biodiversity Action Plan. After an extensive
consultative exercise, a draft Action Plan has been developed, which is
designed to complement the National Conservation Strategy and the
provincial conservation strategies. The draft Action Plan identifies causes
of biodiversity loss and suggests a series of proposals to conserve
biodiversity in the country.1
4.3
LAWS AND REGULATIONS
The Pakistan Environmental Protection Act, 1997 is the basic legislative

tool empowering the government to frame regulations to protect
environment. While a basic policy and legislative framework for
protection of the environment and overall biodiversity is now in place,
detailed rules, regulations and guidelines required for implementation of
policies and enforcement of legislation are still in various stages of
formulation and discussion. Laws, rules, regulations and standards
directly relevant to the proposed project are described hereafter.
4.3.1 Pakistan Environmental Protection Act, 1997
The Government of Pakistan promulgated the Pakistan Environmental

Protection Act, 1997 on December 6, 1997, to provide for protection,
conservation, rehabilitation and improvement of the environment,
prevention and control of pollution, and promotion of sustainable
development.2 One of the basic objectives of this legislation is to prevent
any activity that can have adverse environmental impact. Section 2 (1) of
the said Act defines adverse environmental impact as impairment of or
damage to the environment and includes impairment of or damage to
human health and safety or to biodiversity or property, pollution and any
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adverse environmental effect as may be specified in regulations framed

under the Act. Requirement for environmental assessment is laid out in
Section 12 (1) of the Act, which states that no project involving
construction activities or any change in the physical environment can be
undertaken unless an Initial Environmental Examination or an
Environmental Impact Assessment is conducted, and approval is received
from the federal or relevant provincial agency. In order to protect
proponents and ensure that the review of an environmental study is
undertaken within a reasonable time-frame, Section 12(4) places a
restraint on the concerned Environmental Protection Agency with regard
to limitation period for review of environmental reports and states that
environmental approval shall deemed to have been accorded one hundred
and twenty days after filing of the environmental study.
4.3.2 Pakistan Environmental Protection Agency
Review of Initial Environmental Examination and
Environmental Impact Assessment Regulations, 2000
The Pakistan Environmental Protection Agency Review of Initial

Environmental Examination and Environmental Impact Assessment
Regulations, 2000, prescribed by the federal government and adopted by
the provincial governments, provide the basis, criteria and procedures for
preparation of environmental studies for all projects likely to impinge on
the environment.1
4.3.3 National Environmental Quality Standards, 2000
The National Environmental Quality Standards2 (NEQS) promulgated
under the Pakistan Environmental Protection Act, 1997, specify
parameters for preservation of the environment. Wastewater generated at
the project site both during the construction and operational phases of the
project and emissions and discharges of vehicles and machinery to be
used during the construction phase must conform to parameters specified
under the NEQS.
4.3.4 Pakistan Penal Code, 1860
The Pakistan Penal Code, 1860, prescribes penalties for violations

concerning pollution of air, water bodies and land. Provisions under this
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Act relating to environment are no longer being enforced after

promulgation of the Pakistan Environmental Protection Act, 1997.
However, pollution offences can still be tried under the Pakistan Penal
Code, 1860.
4.3.5 Sindh Local Government Ordinance
The Sindh Local Government Ordinance contains several provisions

covering the environment and environmental pollution. All land planning,
land use, building control and construction activities relating to the
project vest in the town municipal administration. Town/Taluka
Municipal Administrations are also authorised under the Ordinance to
restrict projects causing pollution to air, water or land, monitor the
environment and may also initiate schemes for improving the
environment either on their own or through the polluters.
4.3.6 Land Acquisition Act, 1894
The Land Acquisition Act, 1894, lays down the legal basis for any
property affected by a project and for compensating affected landowners.
The Act lays down a framework for initiation of proceedings of
acquisition of land for public purposes along with a cash compensation
mechanism for acquired land, structures and damages to cropped area,
including orchards and trees. The said Act does not, however, provide for
rehabilitation and resettlement of displaced population and restoration of
livelihoods. The environmental law, on the other hand, requires full
restoration of livelihoods of affected population. In some cases where
large-scale acquisition is involved and a substantial number of
households have to be removed from the project area, compensation is
provided under specific government policy in the form of alternate land,
as was the case with population affected by the Tarbela and Mangla
dams.
4.3.7 National Resettlement Policy
The government issued the National Resettlement Policy for resettlement

of population displaced by a development project in 2002.1 The Pakistan
Environmental Protection Agency thereafter circulated the National
Resettlement Policy Implementation Guidelines in October 2002.
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4.3.8 Project Implementation and

Resettlement of Affected Persons Ordinance, 2001
This Ordinance was promulgated in 2001 by the federal government to

provide relief to persons or households affected by any project in terms of
loss of land or displacement.1 The project under review is not affected by
the provisions of this law, as it no longer involves temporary dislocation
of present residents.
4.3.9 Sindh Building Control Ordinance, 1979
The Sindh Building Control Ordinance, 1979, empowers development

authorities in the province to frame rules, regulations and bylaws
pertaining to approval of town planning schemes and building plans.
4.3.10 Sindh Wildlife Protection Ordinance, 1972
This law was enacted in 1972 for regulation of activities relating to

protection, conservation and management of wildlife in the province.
Enabling rules were also notified to enforce the Ordinance.
4.3.11 Hazardous Substances Rules, 2003
These Rules were notified in 2003 to streamline procedures for issue of

licences to industries that generate hazardous waste and grant of licences
to businesses for removal of hazardous waste in an environment-friendly
manner.2 The Rules specify procedures to be adopted for disposal of
hazardous waste. The Rules also identify two hundred and forty-two
hazardous substances and synthetic chemicals.
4.3.12 Hospital Waste Management Rules, 2005
Rules to regulate management of hospital waste were notified in 2005 by

the federal government.3 Rule 3 states that every hospital shall make
arrangements for proper management of waste generated at the premises
in accordance with procedures specified in the Pakistan Environmental
Protection Act, 1996, and Rules 16-22 of the said Rules.
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4.3.13 Forest Act, 1927
The Act establishes the powers of the government to designate areas for
reserved forests, village forests and protected forests, and to acquire such
areas for prohibiting or restricting public use of the resources or other
activities.
4.3.14 The Cutting of Trees (Prohibition) Act, 1975
The Act was enforced in 1975 to place restrictions on cutting of trees in

order to restrain unchecked trend of tree felling without replacement.
4.3.15 Protection of Trees and Brushwood Act, 1949
The Protection of Trees and Brushwood Act, 1949 prohibits cutting or

chopping of trees and brushwood without prior permission of the relevant
department in the provincial government.
4.3.16 Employment of Child Act, 1991
Article 11(3) of the Constitution prohibits employment of children below

the age of fourteen years in factories, mines or any other hazardous
employment. The Employment of Child Act, 1991, was accordingly
enacted to comply with the Constitutional provision as also abide by
international conventions and treaties in order to prohibit child labour.
4.3.17 Antiquities Act, 1975
The Antiquities Act, 1975, protects the countrys national and cultural
heritage. The said Act defines antiquities as ancient products of human
activity, historical site, or site of anthropological or cultural interest,
national monuments etc. The said Act was formulated to protect such
antiquities from destruction, theft, negligence, unlawful excavation, trade
and export. It prohibits new construction in proximity of a protected
antiquity and excavation in any area that may contain articles of
archaeological significance. The said Act restrains activity within sixtyone meters or two hundred feet of a protected antiquity.
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4.3.18 Related Laws
Pakistan Environmental Protection Agency has advised that a number of

laws must be studied while preparing an environmental report in order to
ensure that all environmental impacts of a project are appropriately
addressed.1 Some of these are project-specific, some are purely provincial
laws and others apply only to projects undertaken in the province of
origin.
4.3.19 Labour Laws
Construction and operational activities during project implementation can

affect occupational health of workers. Employers are required to abide by
labour laws in respect of their own employees and also to ensure that
contractors too follow the relevant labour laws and rules relating to safety
of the workforce and creating a healthy working environment. The
proponents shall ensure that workers engaged at project site are not
exposed to any danger by monitoring the contractors work frequently
either directly or through the project managers and the project
consultants.
4.3.20 Environmental Guidelines
The Pakistan Environmental Protection Agency Review of Initial

Environmental Examination and Environmental Impact Assessment
Regulations, 2000, stipulate that the Initial Environmental Examination or
Environmental Impact Assessment must be prepared, to the extent
practicable, in accordance with the Pakistan Environmental Protection
Agency Environmental Guidelines for conducting environmental
assessments. These include Guidelines for Preparation and Review of
Environmental Reports,2 Guidelines for Public Consultation,3 Guidelines
for Sensitive and Critical Areas,4 and Sectoral Guidelines for the
Construction Sector.5 In addition, the provincial environmental agencies
have also formulated guidelines not covered by the federal government.
Wherever environmental guidelines are silent on a specific aspect of
environmental protection, the prevalent practise is to follow non-binding
guidelines framed by the United Nations Environment Programme,
World Bank, the Asian Development Bank and other credible national
and international sources.
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INTERNATIONAL LAW AND STANDARDS
The Declaration of the United Nations Conference on the Human

Environment adopted at Stockholm on June 16, 1972 is the first formal
international recognition of the need for protection of the environment
between persons of the same generation and between persons of present
and future generations. The Declaration states that development should be
conditioned with due regard to the environment and the international
interest. The Stockholm Declaration formulates 26 principles and the first
provides substance for the remaining: Man has the fundamental right to
freedom, equality and adequate conditions of life, in an environment of
equality that permits a life of dignity and well-being, and he bears a
solemn responsibility to protect and improve the environment for present
and future generations.
4.5
EQUATOR PRINCIPLES
Leading banks and other financial institutions involved globally in project

finance abide by the Equator Principles as a common framework to
assess and manage the environmental and social risks in project
financing. In essence, the financing institutions adhering to the Equator
Principles have agreed to use the same environmental standards as that of
the World Bank Groups International Finance Corporation (IFC), which
applies a set of performance standards to manage social and
environmental impacts of the project that it finances.1 These performance
standards are:
Labour and Working Conditions;
Social and Environmental Assessment and Management
System;
Pollution Prevention and Abatement;
Community Health, Safety and Security;
Land Acquisition and Involuntary Resettlement;
Biodiversity Conservation and Sustainable Natural Resource
Management, and
Indigenous Peoples and Cultural Heritage.
The Performance Standard relating to Social and Environmental
Assessment and Management System establishes the importance of
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firstly, integrated assessment to identify the social and environmental

impacts, risks, and opportunities of projects; secondly, effective
community engagement through disclosure of project-related information
and consultation with local communities on matters that directly affect
them, and thirdly, the proponentss management of social and
environmental performance throughout the project life-cycle. The
remaining Performance Standards establish requirements to avoid,
reduce, mitigate or compensate for impacts on people and the
environment, and to improve conditions where appropriate. While all
relevant social and environmental risks and potential impacts should be
considered as part of the assessment, these Performance Standards
describe potential social and environmental impacts that require particular
attention in emerging markets. Where social or environmental impacts are
anticipated, the client is required to manage them through its Social and
Environmental Management System consistent with the first Performance
Standard.
4.6
OBLIGATIONS UNDER INTERNATIONAL TREATIES
Pakistan is a partner to various international treaties and conventions on

the conservation of environment and protection of wildlife. The country
is obliged to adhere to commitments specified in these treaties. Pakistan
is co-signatory to a number of international treaties and conventions and
its environmental laws and policies thus must conform to such protocols.
A copy of major treaties signed by Pakistan is annexed to the Pakistan
Environmental protection Act, 1997.1
4.7
INSTITUTIONAL SETUP
The apex environmental body in the country is the Pakistan

Environmental Protection Council, presided over by the Prime Minister
of Pakistan. Other bodies include the Pakistan Environmental Protection
Agency, an Environmental Protection Agency in each province, and an
Environmental Tribunal in each province. The federal and provincial
agencies were originally established under the defunct Environmental
Protection Ordinance, 1983. The powers of these agencies have been
strengthened under the Pakistan Environmental Protection Act, 1997. The
Environmental Protection Agency, Government of Pakistan, has been
empowered to receive and review environmental assessment reports of
projects, and accord or with-hold environmental approval in respect of
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the Islamabad Capital Territory or for projects with trans-provincial or

national impact. Regulation 11 of the Pakistan Environmental Protection
Agency Review of Initial Environmental Examination and Environmental
Impact Assessment Regulations, 2000, states that the federal (or
provincial) agency shall make every effort to carry out its review of the
Initial Environmental Examination within forty-five days of issue of
confirmation of completeness of the Initial Environmental Examination
report under Regulation 9, and a minimum of ninety days in respect of an
Environmental Impact Assessment. The federal government has also
devised procedures for review of environmental reports.1
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DESCRIPTION OF THE PROJECT
This section of the study renders a detailed account of the project and its
salient features, such as location, components and various phases. Inputs
and discharges relevant to different phases of the project, such as water,
fuel, electricity, materials, wastes, emissions, and disposals etc., have also
been examined as a response to possible environmental concerns.
5.1
PROJECT OVERVIEW
The proposed project is to be implemented close to the proposed site of

Ghulam Muhammad Mahar Medical College on Sukkur Bypass, Sukkur,
and shall have a basement floor for vehicle parking and services, and
eight floors, including ground floor. Detailed description of the project is
given in subsequent sections of this chapter. The hospital building has
been designed according to building rules, regulations and bylaws of
District Government Sukkur and takes into account the project areas
seismic character.
5.2
ALTERNATE SITES
The proponents considered a number of sites in Sukkur to construct the

proposed hospital but had to reject alternatives due to various reasons
such as high cost of land, lack of physical infrastructure, congestion, and
non-suitability of the site. The present site has been made available to the
proponents free of cost by the Government of Sindh and is located
outside the city on a bypass road to an intercity route. The previous site
within Civil Hospital, Sukkur, was not entirely suitable even though it
had the advantage of quick access for city residents. Moreover, it would
have involved temporary displacement and rehabilitation of existing
occupants at the former site. Considering the needs of the proponents, the
present site is environmentally sound to the extent that location of the
project in a fully-developed area of the city would have been
inconvenient for people desirous of availing medical facilities for reasons
of congestion. The new site has the following advantages:
It is located on a wide road away from congested parts of the
city, thus allowing quick and free access;
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Land for the proposed project has been provided free of cost to
the project proponents by the Government of Sindh, which has
resulted in savings that have been utilised to build additional
facilities into the project design;
The location is such that it will be easy for patients to reach
from within the city and will especially be convenient for
patients from outlying areas and nearby towns and cities;
Since the proposed project is meant essentially for workers, the
new site is closer to the industrial areas;
It is close Sukkur Airport and the National Highway, and thus
there is quick access for patients to the proposed hospital;
It provides medical coverage in an area where such facilities are
currently deficient, and
It can serve as an additional teaching hospital for Ghulam
Muhammad Mahar Medical College when it is ultimately
relocated from the city centre.
On the other hand, the selected site suffers from the following few
disadvantages:
Being outside the city, it will not be easily accessible for
residents of the city;
It is at a distance from the General Bus Stand and Railways
Station and thus there is limited quick access for patients to the
proposed hospital, and
There are no allied medical facilities in the project area that can
complement the proposed hospital;
Advantages of the selected site nonetheless far outweigh disadvantages
and considering the objectives of the proponents, there was no call for the
proponents to look further for alternate site.
5.3
OBJECTIVES OF THE PROJECT
Main objectives of the proposed project are:

Provision of international standard secondary level healthcare
services for especially industrial workers;
Provision of international level diagnostic service to about
1,000 patients per day;
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Provision of outdoor emergency healthcare services of

consultant-level conforming to international standards and
international best practices to at least 500 persons per day;
Provision of indoor emergency healthcare services conforming
to international standards and international best practices to
around 200 patients per day;
to international standards and international best practices
required for acute burn cases of up to twenty patients;
to international standards and international best practices
required for acute cases other than burns of up to twenty
patients, and
Provision of support services conforming to international
standards and international best practices in emergencies,
including burn in respect of CSSD, HVAC, power etc.
5.4
PROJECT SITE
The project site is to the south-west of the city. Total size of the plot is
217,815 square feet in the form of a compact rectangular block. The
project site is about a kilometre from the Railway Station, 9 kilometres
from General Bus Stand, 8 kilometres from Sukkur Airport and 6
kilometres from National Highway. River Indus is less than a kilometre
south of the project site. The proposed site is bounded on all sides except
the north by agricultural areas under cultivation. Land towards the west
however is being rapidly brought under land development. Daddo Canal
is to the north of the project site across Sukkur Bypass.
5.5
PROJECT COMPONENTS AND ACTIVITIES
Key project components and activities are shown in Table 5 overleaf and
described hereafter.
5.5.1 Land Acquisition
The first activity undertaken for the proposed project was procurement of
land, which has been provided free of cost by the Government of Sindh.
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An area measuring 217,815 square feet has thus been made available for
implementation of the project. The plot is available for occupation and
free of encumbrances. There are thus no major social issues arising from
dislocation of and compensation for former landowners or displacement
of any unauthorised occupant.
5.5.2 Surveying and Site Investigations
A topographical survey was conducted to measure and demarcate the area

and gauge ground elevation (Appendix IV). Soil investigations
collected samples from six boreholes and performing laboratory analyses
to determine physical and chemical characteristics of the soil and its
bearing capacity.1 The soil is suitable for construction of the proposed
eight floor building and has the requisite bearing capacity. Water samples
were taken from the project site to determine its quality. The project area
was also tested for noise and a survey was carried out to determine traffic
on Sukkur Bypass in order to work out possible impact of project-related
traffic on the local environment during operation.
5.5.3 Design and Engineering
During this component of the project, the hospital was designed on the
basis of information collected during surveying and site investigations
discussed above, and guidelines delivered to the project designers by the
proponents. The design included overall layout of the hospital, type and
location of various services such as electricity, oxygen lines, airconditioning, natural gas, sprinkler system, other fire-fighting
arrangements, elevators, telecommunications, water supply and sewerage.
The proposed project has been planned according to contemporary
principles of planning and design criteria of the District Governments
building regulations and by-laws and international best practices. The
project designers have strictly followed the seismic code to protect the
structure against seismic activity. Building plans of the proposed structure
are shown at Appendix V.
5.5.4 Selection of Contractor
This component of a project involves selection of the contractor,

transportation of construction machinery and equipment to the project
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site, and establishment of Project Office. A contractor shall be selected

after a pre-qualification and bidding process. Facilities for construction
include site office, equipment yard, material yard and allied services, all
of which will be established at the site.
5.5.5 Site Preparation
Site preparation is a major component of a project and involves earthmoving machinery and equipment to make the site suitable for
subsequent works. The site is plain and has no vegetation cover and thus
there will not be any green losses. The site will be dug up to a maximum
depth of twelve feet to remove earth for the basement and foundations.
Bulldozers, graders, excavators and dumpers will be used for levelling,
grading operations and pitting the land.
5.5.6 Construction
Construction has not started at the project site. Typical activities to be

conducted during construction in addition to site preparation and
excavation for basement shall include installing of pilings, masonry work,
concrete work, asphalt work, and installation of service systems (such as
power generators, boilers, air-conditioning plant etc.). It is expected that
construction shall take approximately twenty-four months, including time
spent on land clearing, excavation and piling.
5.5.7 Finishing and Furnishing
Finishing and furnishing process shall commence after completion of the

structure, with major focus on installing hospital equipment and allied
facilities. Finishing and furnishing of the hospital shall be according to
international standards.
5.5.8 Services
Services planned for the building include water supply and drainage,
sprinkler system, elevators, telecommunications, oxygen lines, natural
gas, electrification, water supply and sewerage, wastewater treatment
plant and incinerator.
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5.5.9 Operation of the Project
Upon completion, the hospital shall be handed over for operation to the
Workers Welfare Board, which is a subordinate organisation of Labour
Department, Government of Sindh. The hospital shall provide medical
facilities especially for workers and their families. Annual recurring cost
shall be about Rs. 236.11 million, which includes Rs. 75.76 on
establishment charges and Rs. 160.35 million on operational expenses.
5.6
SIZE AND MAGNITUDE OF THE OPERATION
The proponents are planning construction of an eight floor state-of-the-art

hospital, including the ground floor, on a plot measuring 217,815 square
feet, with total covered area of 248,360 square feet. Estimated cost of the
proposed project is tentatively estimated at Rs. 2.7 billion. The building
shall rise an approximate one hundred and twenty-eight feet from the
present ground level. In compliance of building regulations, an area of
134,800 square feet, or about sixty-two percent of the plot size, has been
earmarked as open space to be utilised as passages, setback and vehicle
parking. Some of the open area would be used as green belt with trees,
plants and flowerbeds. Setback in front of the building shall be available
for temporary parking and incoming ambulances.
5.7
COVERED AREA AND DISTRIBUTION
Distribution of space on each floor is indicated in Table 6 overleaf. The

building shall have admirable elevation with curtain windows and
aluminium composite panels on all sides, granite and aluminium cladding
that will enrich aesthetic values of the area. The building shall be erected
with additional concrete for structural support and one hundred and fortyfour RCC columns rising to the uppermost levels. There shall be RCC
retaining walls and contiguous piles all around the constructed area of the
basement to provide complete protection to the structure. The basement,
with roof height of sixteen feet, shall have covered area of 36,291 square
feet and shall be used for vehicle parking, consultation and services, such
as mechanical/electrical room, storage, medical gases, offices, waiting
areas, staff lockers, and a large kitchen. About 12,600 square feet within
the basement shall be available for parking of vehicles of hospital staff.
There shall be a total of eighty parking bays for cars and three hundred
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and twenty spaces for motor-cycles. The basement shall have a ramp
providing easy access to the ground level. Entrance into the basement
shall be from rear side of the floor. The width of the ramp will be twelve
feet with a gradient of 1:8 to 1:10, and minimum clearance shall be ten
feet.
The basement shall be well lit with fluorescent markings on the floor
demarcating direction of traffic and exits. There shall be clearly marked
bays, sufficient room for positioning and reversing of vehicles, and
rubber padding along the walls for fender protection. Exhaust from the
parking floor would be effectively expunged through mechanical
ventilators to facilitate proper circulation of fresh air. The basement shall
have double driveways with a width of just under twenty feet. The
parking floor will be equipped with fire hydrants and fire hose reels,
smoke alarms, fire alarms and emergency telephones, all of which will be
clearly identifiable. The basement shall also have appropriate drains (12
x 12 deep rain water drain with steel grating) to carry water in case of
flooding and pumps to drain out water if there is excessive flooding. The
front gate on Sukkur Bypass shall be twenty-four feet wide and shall have
a guardroom. There shall be a pole barrier at the main gate, along with
road blocker and scanner. The rooftop shall be used for cooling towers
and mechanical purposes.
5.8
CONSTRUCTION PHASE OF THE PROJECT
This section of the study describes different aspects of the construction

phase, ranging from contracting arrangements to environmental issues.
Main activities during construction phase shall be:
Selection of a construction contractor;

Site preparation;
Excavation for basement;
Excavations for pilings;
Installation of pilings;
Masonry works;
Concrete works;
Asphalt works;
Installation of service systems, such as air-conditioning plant,
elevators, wastewater treatment plant, incinerator etc., and
Finishing, including installing of medical equipment.
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5.8.1 Contracting Arrangements
The construction contractor will be appointed by the proponents on

recommendation of the project consultants after a pre-qualification and
bidding process. All efforts will be made to ensure that the selected
contractor has an established track record and would be able to complete
the project within the stipulated time-frame of twenty-four months and
has sufficient experience to ensure that there is no adverse impact on the
environment. A maximum of two hundred workers would be required at
the site at peak of construction. Skilled workers shall include engineers,
overseers, carpenters, steel fitters, scaffolders, masons, plumbers,
electricians, curtain wall glass fixers, aluminium cladding fixers,
aluminium doors and windows fixers, HVAC personnel and supervisors.
Unskilled workers shall comprise helpers of the skilled workers.
Mitigation: The contractor will be directed to employ maximum number
of casual labour from the project area to generate employment
opportunities for local labour and provide them with training and
experience. Since workers to be engaged shall be mostly local, a
construction camp will not be necessary at the project site.
5.8.2 Vehicles and Equipment
The contractor will be directed by the proponents to take all possible

measures to see that construction does not impinge on the environment.
Mitigation: Construction vehicles and equipment at the project site
during excavation and piling works and the main construction phase are
indicated at Table 7 overleaf. The exact number of vehicles and
equipment in use at the site at any given time will vary according to work
schedules and work momentum. The contractor will be advised to use
new vehicles, machinery and equipment to maintain emissions and noise
at lowest possible levels. All equipment will be transported to the site
from main roads and shall not pass through the city or heavily built-up
residential areas. During early phase of piling works, two or three
truckloads of different types of construction material shall be delivered to
project site per day, increasing to about five to eight at the height of
construction activity. Arrival timing of such equipment and construction
materials will not be concurrent and shall take place when there is
minimal disturbance for local population.
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5.8.3 Emissions and Discharges
Construction equipment and vehicles can discharge exhaust emissions

containing CO 2 , CO, NO x , SO 2 , particulate matter and generate dust from
earthwork. The primary source of emissions to air during construction
activities will be diesel engine-driven generator exhaust. Other emission
sources include construction machinery and project vehicles, and dust
from construction activities and movement of vehicles.
Mitigation: Since vehicles and equipment to be used shall be in good
working condition and under due maintenance, as per instructions to the
construction contractor from the proponents, emissions shall be within
tolerable limits. The proponents shall monitor pollution levels regularly
and instruct the contractor to cover the perimeter with windshields and
cordons to minimise dust pollution and sprinkle the grounds frequently to
prevent dispersal of dust.
5.8.4 Construction Materials
Construction materials will include cement, sand, crush, bricks, steel bars,
paints, asphalt, piping materials, electrical materials, cladding, glass and
finishing materials, which shall be transported to the project site in bulk
quantities on need-basis.
Mitigation: The proponents are aware of Green Building so as to use
environment-friendly construction materials, if available in the market,
and fire-resistant materials to the extent possible. The geotechnical
investigation has recommended that fine aggregate for concrete work
may be obtained from local sources meeting ASTM gradation
requirements. Accordingly, quarry materials, meeting technical
requirements and quality, will be procured from the nearest quarry
licensed by the government, which shall mean less transportation costs as
well as lesser emissions from trucks carrying such materials. Materials
such as cement, paint and aluminium cladding shall be purchased either
directly from the factories or from local markets, or imported. Noise
absorbent materials, if available in the market and if cost-effective, shall
also be considered for use. All construction materials to be procured for
the project shall be subject to testing and prior approval by the Project
Consultants in order to maintain quality standards. Cost consideration
shall not be a major factor in selecting raw materials.
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5.8.5 Other Supplies
Main supplies required during the construction phase of the project shall
include water, fuels, power and routine construction accessories.
Requirement of water shall vary according to the quantum of construction
activity and human consumption during the construction phase. Peak
consumption could reach 5,000 gallons per hour.
Mitigation: There is sufficient groundwater in the region and
consequently depletion of groundwater is unlikely. In fact, due to
proximity to the canal and River Indus, the water table is on the high side
in any case. Fuels for construction equipment and vehicles, comprising
mainly diesel and petroleum, are available at nearby locations. Peak
consumption will be about 1,000 litres per day. Temporary electricity
connection will be obtained from Hyderabad Electricity Supply
Company, which will augment diesel generators. Construction foremen
shall ensure that all supplies either for construction or for personal
consumption of construction crew are procured regularly and on timely
basis so that there are no delays and that workers are not inconvenienced.
Construction projects involving high-rises create a great deal of liquid as

well as solid waste that can impair local environment. Steps thus need to
be taken to ensure appropriate collection and disposal of all forms of
waste.
Mitigation: A waste management contractor is to be appointed by the
construction contractor to carry away all forms of waste from the project
site for disposal in an environment-friendly manner.
5.8.7 Waste Streams
Waste generated at a site can be liquid as well as solid waste. Liquid

waste consists of oils and oily water from maintenance of equipment and
vehicles, accidental leakage or spillage from vehicles, equipment or
storage, wastewater from construction activities and domestic sewerage
from the project office. Solid waste requiring disposal will consist of
excavated earth, excess or used or rejected construction materials, scrap,
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warehouse waste, workshop waste and domestic solid waste from the
project office.
Mitigation: Table 8 overleaf provides a description of different types of
wastes that are expected to be generated during the construction phase
and planned disposal option. No vehicles and equipment shall be repaired
at the project site, thus eliminating spillage of oils or oily water that can
damage sub-soil. The contractor will issue instructions to foremen and
workers that any leaks from machines and equipment during use must be
scooped up immediately and placed in dedicated bins. Sewage will be
treated in a closed system and effluent will be drained into municipal
facilities after sieving. Alternatively, grey water will be sprinkled on
unpaved sections within the construction site. Sieved substances, which
will be dumped at municipal waste disposal site, will not be of character
injurious for the environment.
It will be ensured that liquid and solid waste is minimised and that all
form of waste is carried away from the project site and disposed in a
manner whereby it does not impact adversely on the local environment.
All solid waste will be collected at the site at designated spots from where
it shall be removed to municipal skips on a regular basis by the waste
management contractor. Excavated earth may not be required at the
project site and will be sold for reuse. No excavated earth will be dumped
either on adjoining plots or on nearby properties. Recycling or reuse of
waste material shall be the preferred option but when not possible, solid
waste will be treated and disposed of appropriately.
5.9
OPERATIONAL PHASE OF THE PROJECT
Different aspects with bearing on environmental issues during the

operation of the proposed project are discussed in the following sections.
5.9.1 Demands on Services
Demands on services in relation to a particular project can be worked out

on the basis of covered area and the nature of activity. Architectural
drawings as a rule of thumb cater for 80 square feet per person. Based on
covered space of 212,069 square feet, excluding the basement, the
building shall be sufficient for an absolute maximum of two thousand six
hundred and fifty-one people. It is estimated that there shall be a
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maximum footprint of about twenty-two hundred people through a day,

based on six hundred and five employees, two hundred patients, four
hundred patients visitors, and a thousand outdoor patients. Maximum
average presence at any given time outside of visiting hours will be about
five hundred and fifty persons.
Mitigation: All electricity, telephone, natural gas, water and wastewater
lines, whether cables or drains, shall be subterranean. The quality of
materials used and standard of construction shall be high, which will
ensure that there are minimum maintenance costs. The proponents shall
make applications for all connections at the appropriate time towards the
completion stage of the project so that the hospital can become
operational immediately upon completion. According to WAPDA energy
requirement criterion of fourteen watts per square feet of covered area,1
electricity need shall be about 1,515 KW, which can be purchased from
Hyderabad Electric Supply Company. Natural gas supply shall be
obtained from Sui Southern Gas Company and will be provided through a
low pressure dedicated pipeline. Approximate natural gas utilisation shall
depend on the type of air-conditioning plant and whether it would use
natural gas as source of fuel. However, according to generally accepted
yardstick of natural gas usage of 15-20 cubic feet per hour for every 100
square feet of area covered, the hospital shall need 42,414 cubic feet of
natural gas per hour during winter months. This calculation is based on
total covered area excluding the basement, which shall not require
heating. The project area has good coverage of both electricity and
natural gas and alternate sources of fuels or energy would not be required.
Telephone connections will be obtained from local telephone companies,
which have the necessary network in place in the project area. The
building shall also have an inter-com system operated through internal
telephone exchange and switchboard. Two tube-wells with combined
capacity of 4 cusecs that can draw 90,000 gallons per hour, shall be
sufficient to meet water requirements of the proposed project. Table 9
overleaf provides an indication of demands on various resources, such as
electricity, natural gas, water usage, wastewater generation and storm
water disposal, using various management techniques in addition to
covered area.
5.9.2 Water Usage
Water shall be used for the following main purposes at the proposed
hospital:
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Personal consumption of hospital employees, excluding

showers and cooking;
Medical needs and personal consumption of indoor patients,
excluding cooking and including dry baths;
Medical needs and personal consumption of outdoor patients;
Personal consumption of patients visitors (short-time only);
Operation of air-conditioning plant (depending on type);
Medical equipment and laboratories;
Kitchen;
Janitorial, and
Irrigation.
The following table provides an indication of water needs of the proposed
project based on the management consultants estimates.
TABLE 10: WATER USERS
Category
Hospital employees
(doctors and staff)
Indoor patients
Outdoor patients
Patients visitors
Kitchen
Janitorial
Irrigation
TOTAL:
Maximum
no. of
people
per day
Estimated
duration
of stay
Average no. Use of water

of people at (percentage
premises
of per capita
per hour
average)
605
200
1,000
400
-------
8 hours
24 hours
1 hour
1 hour
-------
202
200
42
17
-------
25
50
6.25
3.125
Need-based
Need-based
Need-based
2,205
---
461
---
Maximum per capita consumption of water in larger urban centres in

Pakistan is a hundred gallons per day. Per capita per day consumption of
water for the country as a whole, however, is lower at 84.44 gallons.
Demand of water in a hospital is vastly different in comparison to that of
a housing society or a pure apartment complex. Considering that the
building has been designed for a maximum of two thousand six hundred
and fifty-one people based on covered area of 80 square feet per person,
water could be required for as many people. The maximum number of
people present in the hospital daily will be about twenty-two hundred.
There are no reliable figures for water usage at a hospital and details of
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water consumption collected from different hospitals have yielded erratic

results, mainly because of a common single connection and multiple
users, such as hospital, residential quarters using water from the same
source, and commercial and irrigation needs. Table 11 illustrates possible
water requirements of the hospital based on estimated commercial use of
water corresponding to per capita use of 100 gallons per day, typical of
urban centres, as well as 84.44 gallons per day, which is the present
average for the country as a whole.
TABLE 11: AVERAGE DAILY WATER REQUIREMENTS
Total Number of People
Average Per Capita
Using the Premises:
Water Demand (gpd)
2,205 (Absolute number --see Table 11)
100
605 hospital employees
100/0.25
200 indoor patients
100/0.50
1,000 outdoor patients
100/0.0625
400 patients visitors
100/0.03125
Average Daily Demand (persons)
Average Daily Demand for green areas/plantations
Average Daily Demand for kitchen
Average Daily Demand for cleaning
Total Average Daily Demand
Add 10 Percent Cushion
Total Average Daily Water Requirement (100 gpd)
Total Number of People
Average Per Capita
Using the Premises:
Water Demand (gpd)
2,205 (Absolute number --84.44
see Table 10)
605 hospital employees
84.44/0.25
200 indoor patients
84.44/0.50
1,000 outdoor patients
84.44/0.0625
400 patients visitors
84.44/0.03125
Average Daily Demand (persons)
Average Daily Demand for green areas/plantations
Average Daily Demand for kitchen
Average Daily Demand for cleaning
Total Average Daily Demand
Add 10 Percent Cushion
Total Average Daily Water Requirement (84.44 gpd)
Total Water
Demand (gpd)
220,500
15,125
10,000
6,250
1,250
32,625
5,000
1,500
1,000
40,125
4,013
44,138
Total Water
Demand (gpd)
186,190
12,772
8,444
5,278
1,056
27,550
5,000
1,500
1,000
35,050
3,505
38,555
Peak water demand of the hospital for all uses would be could 44,138
gallons per day subject to an absolute maximum of 220,500 gallons per
day based on maximum per capita consumption of a hundred gallons per
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day typical of residents in larger urban centres. Per capita per day
consumption of water at 84.44 gallons would work out at daily
requirement of 38,555 gallons, subject to an absolute maximum of
186,190 gallons per day.
Mitigation: Two tube-wells with capacity of 4 cusecs at the project site
will meet water needs of the proposed hospital. Water conservation
measures discussed in subsequent sections of this report shall ensure that
water resources are not wasted.
5.9.3 Wastewater Generation
The volume of sanitary sewage depends on the number of persons using

the premises every day. As per standard yardstick adopted by
environmental engineers, eighty-five percent of water used is converted
into sewerage.1 Assuming that an absolute maximum of 220,500 gallons
per day will be used at the proposed hospital as per calculations explained
in the preceding section of this chapter, the volume of sewerage will be
about 187,425 gallons per day Wastewater generation based on per capita
water usage of 84.44 gallons per day will be 158,262 gallons per day.
Actual, or estimated wastewater generation, shall be 32,842 gallons per
day or 28,097 gallons per day on the basis of per capita water use of 100
and 84.44 gallons, respectively, as calculated in the following table.
TABLE 12: AVERAGE DAILY WASTEWATER GENERATION
Total Number of People Using the Premises:

Absolute Maximum Daily Water Requirement (100gpd)
Total Wastewater Generation (85 percent)
Estimated Daily Water Requirement (100gpd)
Absolute Maximum Daily Water Requirement (84.44gpd)
Estimated Daily Water Requirement (84.44gpd)
Total Water
Demand ( 100 gpd)
220,500
187,425
38,638
32,842
186,190
158,262
33,055
28,097
Note: The above calculations of water needs do not include water used for irrigation
Mitigation: Liquid waste effluents at the project will primarily consist of

commercial sewerage of more or less domestic nature. Treated sewerage
from the hospital will be used for irrigation purposes and the surplus shall
be discharged into municipal sewers. It is anticipated that since water to
be consumed at the premises shall more or less be domestic in nature,
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wastewater will have not have any pollution load in terms of Biological
Oxygen Demand (BOD), Chemical Oxygen Demand (COD), oil and
grease etc., and can be safely discharged into the sewerage network
without clogging the system or further aggravating chemical properties of
sewage. Even though wastewater will be more or less domestic, a
wastewater treatment plant is envisaged in the project so as to ensure that
treated water is within the National Environmental Quality Standards
limits.
5.9.4 Water Balance
Completion of projects that require a large amount of water during

project implementation or for operation can deplete water resources in the
project area, thereby causing serious environmental concerns. It is thus
often necessary to assess the water balance for such projects.
Mitigation: A study conducted by the World Bank in 2006 estimated that
the groundwater potential of the project area is about 750 million litres
per day.1 The proposed project shall draw water from two 2 cusec tubewells at the site. There is no need to assess water balance in the project
area through a hydrological study. Quantification and estimation of water
balance is usually necessary for large-scale housing projects, such as new
townships, or industries relying heavily on water as an industrial input.
No measures are necessary to address the water balance within the project
area due to reasons explained above. Despite extensive urban as well as
agricultural use, water balance in the area remains at high levels due to
proximity of River Indus that runs to the east and south of the city and the
Daddo Canal to the north of the project site. Operation of the hospital
shall not lead to any exclusive depletion of groundwater or municipal
water resources. Moreover, there are no municipal regulations or
environmental laws requiring calculation of water balance at the project
site.
5.9.5 Water Tank
Sufficient storage capacity of water must be maintained at all times to

meet water needs of the building and for fire-fighting.
Mitigation: The main source of water shall be tube-wells. An overhead
water tank, measuring 8,000 cubic feet, shall be constructed at roof level.
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Water shall be pumped into the overhead water tank regularly from the
tube-wells to keep water level above the minimum hourly need.
Sufficient water storage capacity will thus be available to meet all needs.
The water tank shall be regularly chlorinated and chemically treated to
maintain healthy consumption standards. The tank shall be cleaned at
regular intervals. The overhead water tank shall have appropriate
waterproofing with thick concrete walls, floor, top and foundations, to
eliminate leakages, precipitation and escape of moisture.
5.9.6 Disposal of Sewerage
It is anticipated that since water to be consumed in the hospital will more

or less be for domestic needs not involving any chemical processes,
wastewater will have not have any pollution load in terms of Biological
Oxygen Demand (BOD), Chemical Oxygen Demand (COD), oil and
grease etc., and can be safely discharged into sewers without clogging the
system or further aggravating chemical properties of sewage.
Mitigation: Sewerage drains shall be twelve inch thick U-PVC pipe,
sufficient to carry the quantum of wastewater generated at the premises.
Sewerage drains within the compound shall be of a size compatible with
wastewater generation capacity of the proposed hospital. Most if not all
the wastewater is likely to be reused at the site after treatment and only
surplus treated water shall be released into the municipal sewerage
network.
5.9.7 Vehicular Traffic
The building bye-laws lay down that not less than one car parking space
shall be provided for every one thousand square feet of floor area of a
commercial building, excluding basement. Accordingly, based on total
covered space of 212,069 square feet, excluding basement, the minimum
car parking space must cater for at least two hundred and twelve cars.
However, this restriction does not apply to hospitals and government
buildings that are in any case exempt from building regulations in the
Sindh Province.
Mitigation: The basement floor has an area of 12,600 square earmarked
for parking of up to 80 cars and 320 motor-cycles of hospital employees,
including ten clearly designated spaces for disabled parking. Parts of the
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open area around the hospital, measuring about 17,200 square feet, shall
be available for vehicle parking of patients and visitors. There will be
negligible vehicular pollution added to the local environment when the
hospital enters operational phase. Chapter 10 relating to the Traffic
Impact Analysis discusses vehicular traffic arrangements in greater detail.
5.9.8 Solid Waste
Considering the purpose for which the building is to be employed, solid

waste generation at the hospital will be in the range 0.5 kg to 0.8 kg per
capita per day, following the yardstick for solid waste generation in urban
centres. Assuming total presence of an average of about twenty-two
hundred people per day generating solid waste, the quantity of solid waste
generated shall be a maximum of two hundred and thirty-one kgs per day
at the daily rate of 0.5 kg per capita and about three hundred and sixtyone kgs per day at per capita waste generation rate of 0.8 kg. It is not
possible at this stage to calculate the BOD/COD load of solid waste that
shall be generated when the hospital comes into operation. However,
since the solid waste shall not be industrial in nature, COD/BOD load
shall be well within environmental parameters
Mitigation: Solid waste shall be carried away regularly from the hospital
and dumped at the nearest municipal skip. All medical waste shall be
incinerated at the facility to be established at the site. A number of
measures shall be adopted for reduction of solid waste, as discussed in
Chapters 7 and 9.
5.9.9 Wastewater Treatment Plant
Grey water, also known as sullage, is non-industrial wastewater generated

from domestic processes such as dish washing, laundry and bathing. Grey
water comprises 50-80 percent of residential wastewater. Grey water
consists of wastewater generated from all of the houses sanitation
equipment except for septic tank (water from toilets is black water, or
sewage). Grey water is distinct from black water in the amount and
composition of its chemical and biological contaminants (from faeces or
toxic chemicals). Grey water gets its name from its cloudy appearance
and from its status as being neither fresh (white water from groundwater
or potable water), nor heavily polluted (black water). According to this
definition, wastewater containing significant food residues or high
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concentrations of toxic chemicals from household cleaners etc. may be

considered dark grey or black water. Concerns over dwindling reserves
of groundwater and overloaded or costly sewage treatment plants in
recent years has generated much interest in reuse or recycling of grey
water, both domestically and for use in commercial irrigation. However,
concerns over potential health and environmental risks means that many
jurisdictions demand such intensive treatment systems for legal reuse of
grey water that the commercial cost is higher than for fresh water.
Despite these obstacles, grey water is often reused for irrigation. In
drought zones or areas hit by hose-pipe bans (irrigation restrictions), grey
water can be harvested informally by manual bucketing. In the third
world, reuse of grey water is often unregulated and is common.
Mitigation: Liquid waste effluents will consist of sewerage of more or
less domestic nature. As per standard yardstick adopted by environmental
engineers, eighty-five percent of water used is converted into sewerage.
Assuming that a maximum of 38,638 gallons of water are used at the
hospital per day, the volume of wastewater generation will be an
estimated 32,842 gallons per day. As wastewater will be non-industrial in
nature, no prior treatment is required, but a wastewater treatment plant is
nonetheless embedded in the project design. Excess treated water, which
will be well within limits set down by the National Environmental
Quality Standards, will thereafter be released into municipal drains. Most
of the treated water shall however be used at the project to irrigate green
belts and plantations. The proponents are in negotiations to procure the
Clear Water SBR sewage treatment plant manufactured in the
Netherlands. Details of the proposed plant are placed at Appendix VI.
The advantages of this system of sewerage treatment are:
High purification performance;

Safe operation;
Robust engineering;
Good resilience to load fluctuations;
Automatic operational accounting;
Electronic fault reporting, and
Remote monitoring.
The proponents have tentatively selected the CW 10000-S model, which

consists of spiral sieve, equalisation tank and reactor. Particles larger than
3 mm are captured by the spiral sieve making the use of the clear sludge
possible. Wastewater flows into the equalisation tank and is stored there.
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It is thereafter pumped into the reactor, where it is biologically purified

with micro-organisms. Treatment is carried out in following five phases:
Filling: The reactor is filled with wastewater from buffer tank;
Reaction/Aeration: A diaphragm pipe aerator blows oxygen
into the water, creating activated sludge comprising microorganisms and bacteria. Impurities in wastewater are
decomposed biologically during this phase;
Sedimentation/Settling: Wastewater is no longer aerated
during settling phase. Activated sludge settles on the tank floor
due to cessation of turbulence. Since sludge settles completely
on the tank floor, upper part of clarified water is of extremely
good quality;
Clarified Water Removal/Extraction: Clarified water is
pumped out during this phase by employing clarified water
pump, and
Excess Sludge Removal: Since new activated sludge is formed
during every aeration process, excess sludge is pumped into the
sludge storage tank during the final phase, so that the reactor
always contains the optimum amount of sludge.
The plant has a flexible design that can be modified for large or small
volumes of wastewater. Sludge created at the wastewater treatment plant
shall be carried away from the site by the waste management contractor
for dumping at the municipal rubbish disposal, after prior approval of the
concerned municipal authority. It is expected that the wastewater
treatment plant shall be functional by the time the project comes into
operation. The wastewater treatment plant shall have excess capacity that
could be employed for treatment of wastewater generated at nearby
housing schemes that are presently under development.
5.9.10 Waste Management Team
In compliance of Rule 4 of the Hospital Waste Management Rules, 2005,

a team must be appointed by the hospital administrator to disposal of
medical waste in an environment-friendly manner.
Mitigation: The proponents shall ensure that a Waste Management Team
is constituted at the same time as the proposed hospital comes into
operation, and shall discharge duties as specified under the said Rules.
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5.9.11 Waste Management Plan
Rule 15 of the Hospital Waste Management Rules, 2005, provides for

preparation of a Waste Management Plan by the waste Management
Officer nominated as a member of the Waste Management Team. Such
plan must be approved by the Waste Management Team.
Mitigation: The proponents shall ensure that the Waste Management
Officer appointed under Rule 4 formulates a Waste Management Plan
that is approved by the Waste Management Team and that it is
implemented. The Waste Management Plan shall include, but will not be
limited to, guidelines prescribed in the said Rules and shall correspond to
best international practices and would be subject to periodical review.
The Plan shall cater for waste segregation, collection, transportation,
storage and disposal, as also for waste minimisation and reuse, and devise
procedures for immediate measures for control and rectification in cases
of accidental spills and leakages of hazardous materials and hazardous
waste.
5.9.12 Incinerator
Incinerators must be installed at a hospital since some hospital waste,

especially used syringes, can be a serious environmental hazard.
Mitigation: Although the proponents intend to engage a waste
management contractor for collection of waste from the hospital, an
incinerator shall be installed for disposal of medical waste such as used
syringes, soiled bandages, used X-rays, expired medicines etc. Details of
a possible option are at Appendix VII, which has capacity of 25-1,000
kgs per hour.
Special arrangements must be made where there is likely to be substantial

liquid and solid waste and where there is no collection of waste by
municipality.
Mitigation: A waste management contractor shall be appointed prior to
commencement of project operations to remove all forms of solid waste,
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including sludge from the wastewater treatment plant, for disposal in an

environment-friendly manner.
5.9.14 Elevators
There shall be three locations for elevators with a maximum of seven

cars, from the basement to the upper floors.
Mitigation: The elevators shall be sufficient to carry a minimum of one
hundred persons and shall be large enough to accommodate gurneys. The
set of elevators on the middle of each floor shall be able to open on both
sides. The proponents shall ensure that elevators remain under due
maintenance so that there is no noise and vibrations from the equipment.
There shall also be regular inspections to check the equipment for safety.
5.9.15 Generators
Generators can cause noise pollution, emissions and vibrations, which

can be a source of environmental impairment as well as annoyance for
users of the premises and neighbours.
Mitigation: The proponents must make arrangements for standby
generators in order to ensure that supply of medical services at the
hospital is not interrupted. The proponents shall ensure that the location
of generators is such that it does not create any disturbance. Suitable
arrangements shall be made to clamp down the equipment to eliminate
possibility of vibrations and to place the generators under a canopy to
reduce noise. Finally, the stack shall be connected to a funnel that shall
convey emissions directly to the outside. While installing generators, it
shall be ensured that heat dispersion of the equipment does not impact
unfavourably on the immediate environment. These generators shall be
installed within the mechanical area of the basement.
5.9.16 Air-conditioning Plant
The air-conditioning plant can disturb the environment within the

building through emissions, noise and vibrations and mitigation measures
would thus be required to ensure that it only performs well for comfort of
patients but at the same time is not an environmental hazard.
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Mitigation: The air-conditioning plant shall be placed within the

mechanical area in the basement. The plant shall be properly clamped
down and heavily insulated to eliminate possibilities of vibrations and
noise. It shall be ensured that the air-conditioning plant to be procured is
CFC-free. The air-conditioning plant shall use either electricity or natural
gas as the power source.
5.9.17 Vibrations
Machinery installed in the building, such as the air-conditioning plant,

elevators, tube-well or pumps may cause vibrations that could be a
nuisance for patients as well as neighbours.
Mitigation: Generators, elevators, motor pumps and tube-wells shall be
kept under due maintenance. Since equipment to be installed in the
building will be of the highest quality, there should not ordinarily be
concerns about possible vibrations from their operation.
5.9.18 Noise
Undue noise can likewise be generated by the above-said machinery and

equipment, causing annoyance and discomfort for users and neighbours.
Mitigation: Since the HVAC Plant is to be installed within a wellinsulated mechanical area in the basement, there shall be minimal noise.
The walls shall be padded, which shall reduce noise from the operation of
the air-conditioning plant. Noise from elevators, pumps, tube-wells and
generators shall be kept within acceptable limits by using high quality
equipment and ensuring due maintenance.
5.9.19 Reflection, Heat and Insulation
The design of large structures must contain safety valves to prevent

reflections and provide for measures for heat and insulation as a part of
the environmental aspects of the project.
Mitigation: Following standard construction practices, externals walls
have cavities filled with thermopore sheets to provide insulation against
heat. External walls shall be of hollow block masonry or RCC with 2
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thick rigid insulation installed between finished surface and peripheral

walls. The roof has been designed to cater for heat absorption and
insulation, so as that the building is suitably protected against the
elements, particularly summer heat. The roof top built-up shall be screed
in slope with waterproofing, 2 thick rigid insulation and 1 thick
terracotta tiles. Finally, a colour scheme shall be used within the building
and exteriors in such a way that heat is absorbed during summer months.
Reflections from the large glass windows shall be restricted through use
of tinted glass and drapes or blinds.
5.9.20 Services
Patients and employees at a high-rise hospital must have access to

sufficient services to ensure their safety and comfort.
Mitigation: Various services that may have an indirect or direct impact
on the environmental are embedded in the project design. These include
common areas, wide passages, parking spaces, garbage chutes for
effective and swift waste disposal, access through elevators and
staircases, fire escapes, washrooms, ATMs and public telephones. Male
and female washrooms, with sufficient number of stalls and urinals, shall
be available on each floor, along with disabled toilets, having standard
equipment for facility of users. All washrooms will be equipped with
sensor-fitted urinals and faucets in the washbasins to ensure maximum
economy of water. The washrooms will be maintained by a team of
sanitary workers to keep the premises clean and hygienic at all times. The
proponents shall develop a standard operating procedure to ensure that
washrooms are cleaned frequently and that a log is maintained regularly.
5.9.21 Access
Ample access must be provided in a high-rise not only for ease in

movement but also for evacuation in the event of an emergency.
Mitigation: There are a minimum of six exits at the ground level. Four to
five elevators serve the building from the basement to the Seventh Floor.
The elevators would be manned around-the-clock with attendants for
public convenience and safety. The proponents shall develop a foolproof
mechanism for frequent inspections and service of elevators to guarantee
safety of use, including a logbook of inspections by certified technicians.
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The staircases shall have fireproof doors. Vehicles shall enter and leave
the basement through a dedicated ramp. Fire-escapes shall remain
unobstructed at all times.
5.9.22 Storm Water System
Since rains in monsoon and water can cause flooding, appropriate

measures must be put in place to regulate storm water so that it does not
also at the same time impede activities at the hospital.
Mitigation: The project area does not receive heavy rain throughout the
year, even during the monsoon. However, there shall be drains around the
compound to collect rainwater for swift disposal into the municipal storm
water system through gravity.
5.10 SEISMIC PROVISIONS
A seismic map of the country is placed at Appendix VIII, which shows

that the project area falls in Seismic Zone 2A.1 District Government
Sukkur abides by the Pakistan Building Code Seismic Provisions 2007,
which have been compiled under order of the federal government by the
Ministry of Housing and Works.
Mitigation: The building design has been structured to withstand
possible seismic activity of the level expected in an area typical of Zone
2A. The geotechnical investigation advised that due to the sensitivity of
the project, it should be designed to withstand Peak Horizontal
Acceleration of 0.3 g according to the latest provisions of the Pakistan
Building Code. The building design exceeds this requirement. Further
details about seismic nature of the project area are given in the next
chapter.
5.11 SAFETY OF THE STRUCTURE
A geotechnical investigation has been conducted at the project site.2 Most
failures of structures are probably caused by the failure of foundations,
which are still frequent despite rapid advancements in construction
technologies. The cost of a foundation seldom exceeds one-tenth of the
total cost of a structure whereas the security of the superstructure hinges
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directly on the integrity of the foundations. Attempts to cut costs on

foundations either during preliminary investigations, designing, or in the
use of materials or workmanship can compromise on the quality of the
structure however well it may be raised. Defects in foundations rarely
appear immediately and most become obvious when a building is in
actual use and when remedial action is either too expensive or too
difficult for a variety of reasons. Foundation designing is not an exact
science and the same parameters cannot be applied to all problems that
may arise because of different nature of soils at different sites. Even at the
same site, work methods and different effects of climatic conditions and
groundwater effects on the soil may bear different reactions.
A foundation differs from other parts of the structure insofar as it is
supported by soil, which is a material of uncertain and non-uniform
nature. Further, loads acting on this uncertain material cannot be
calculated exactly and their magnitude and behaviour often depends on
the work methods and weather conditions when the work has been
completed. The failure of a foundation may be of such a nature that it
would be impossible to remedy it an economical cost, in which the loss
may exceed the total cost of the foundation and the structure raised upon
it. There are a number of factors that affect the ability of foundations that
it is not easy to classify them into groups. Generally, these may be due to:
The absence of proper investigation of the soil;
Provision of deficient information about the proposed structure
to the geotechnical investigators;
An erroneous interpretation of the results of such an
investigation;
Lack or absence of coordination between the geotechnical
consultants, project designers, top-supervision consultants and
construction contractors;
Deviations from the design communicated to the geotechnical
investigators;
Faulty design of the foundations;
Behaviour of soil contrary to projections of the geotechnical
investigators, which is rather rare. This could nonetheless be
caused by vibrations, scour, changes in the level of
groundwater, erection of other structures in close vicinity etc.;
Deficient workmanship in the construction of the foundations;
Removal of subsoil water through pumping without resort to
effects on the surrounding environment;
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Use of inferior materials, and

Insufficient provisions in the designs for exceptional natural
phenomena such as earthquakes, thermal and biological
conditions, rainfall and flow of water at a rate greater than
anticipated.
A high-rise building designed without credible soil analyses is the worst
environmental hazard, as was evident in Islamabad during the earthquake
of 2003. Geotechnical analysis of a project site provides vital information
to design foundations. The project designer must be armed with complete
information about soil at a building and whether it has the capability to
carry loads from an engineering structure without causing shear failure
and whether resulting settlement remains within tolerable limits for the
structure proposed to be raised.
5.11.1 Geotechnical and Soil Tests
Soil testing work was carried out from May 28, 2011 to June 14, 2011 to
evaluate safe bearing capacity and other geotechnical parameters to
design the foundation. Six boreholes were drilled using rotary/wash
boring method at the site to a depth ranging from sixty-five to a hundred
feet below natural surface level. Four test pits were dug manually to a
depth of six feet each at different locations of the proposed road works
within the project site. Borehole locations are placed at Appendix IX.
Soil samples were subjected to following types of laboratory tests:
Grain Size Analysis: Grain-size analyses were carried out for
coarse-grained as also fine-grained soil to group particles into
separate range of sizes so as to determine relative proportions
by dry weight of each size range. Soil has thus been classified
according to the Unified Soil Classification System;
Density and Moisture Tests: Samples were tested for moisture
content and density which show that natural moisture ranges
between 4.8 percent to 6.5 percent and dry density varies from
1.7 gm/cc to 1.93 gm/cc;
Specific Gravity Test: This examination is conducted to
calculate void ratio, and it was found that specific gravity
ranged between 2.62 to 2.74;
Direct Shear Tests: The soils were tested to ascertain relative
bearing capacity;
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Unconfined Compression Tests: Samples were tested to

establish soil compression;
Chemical Tests: Soil samples were tested for quality and
presence of chemicals for use of appropriate materials;
Atterberg Limits: Samples were examined to determine
consistency in terms of liquid, plastic and shrinkage limits;
Organic Matter Test: In order to identify organic matter
within the soil, soils samples were tested, which established
range between 0.75 percent to 1.40 percent;
Consolidation Test: Undisturbed samples were tested to
establish consolidation characteristics of soil;
Sensitivity Test: This test is carried out to arrive at the ratio
between unconfined strength of undisturbed and remoulded
samples. The values were found to be between 1.05 to 1.15;
Electrical Conductivity Tests: Samples were tested in this
behalf and the measured range is between 1,490 to 1,940 micro
mohs/cm, and
Un-drained Tri-axial Tests: Samples were tested to confirm
their fundamental material parameters about angle of internal
friction, apparent cohesion and dilatancy angle to predict
behaviour in a large-scale engineering application.
5.11.2 Foundations
Raft foundations have been proposed at least three to three and a half feet
below the floor level of the basement to provide sufficient embedment.
5.11.3 Piling
Bored and driven piles capacity has been determined for different lengths
and diameters. Spacing of piles from centre to centre should not be less
than twice the diameter of the piles.
5.11.4 Bearing Capacity
Safe bearing capacity for double storey structures at three to nine feet
depth below the existing ground level has been proposed at 0.5 tsf for
strip and 0.6 tsf for isolated footings. The safe bearing capacity of raft
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footing at or below fifteen feet of depth for the high rise building of up to
nine floors has been proposed at 1.8 tsf, with bored/driven piles.
5.11.5 Chemical Contents
Results of chemical tests are carried out on soil and water samples to
bring forth results in order to suggest usage of appropriate cement and
other vital building materials. In case there are infirmities in the soil,
special construction materials must be used. Results of chemical tests on
soil and water samples carried out during the geotechnical study suggest
that Sulphate Resisting Cement should be used for all concrete works in
combination with sweet water.
5.11.6 Structural Stability
From the analyses given in Sections 5.11.1 to 5.11.5, it is evident that the
proponents have taken more than sufficient measures to ensure that
structural designing and subsequent construction meet all structural safety
standards.
5.12 SOIL AMPLIFICATION STUDY
A soil amplification study describes whether a soil site is advantageous in

amplifying or in damping earthquake shaking transmitted from bedrock
levels. Such studies are usually taken for large structures, such as
skyscrapers and large urban development projects particularly in areas
highly susceptible to seismic activity. Studies of a number of earthquakes
show that a thick layer of soil can amplify the ground shaking
significantly. Some studies have indicated that soft soil does provide a
kind of cushioning and absorbs seismic waves before these are
transmitted to the surface. For example, liquefaction of a particular layer
in a thick layer may in fact act as an isolator. Considering the size and
nature of the project, a soil amplification study was not considered
necessary for the purposes of structural planning, especially since the
foundations have been designed on the basis of soil characteristics and
the building design is in conformity with the seismic code. Most
significantly, the Pakistan Building Code Seismic Provisions, 2007, have
been framed keeping in view soil characteristics and rock formations all
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over the country. Moreover, a soil amplification study is not required

under the relevant building regulations and by-laws.
5.13 GOVERNMENT APPROVALS, MOUs AND LEASES
Approval of all relevant government departments must be obtained well

in time for various activities so that a projects implementation or
operation is not stalled at any stage. Moreover, non-compliance of legal
and regulatory provisions is in itself a cause for environmental imbalance
as it can create social tensions, especially when illegal construction takes
place and is opposed by the local population.
Mitigation: Since construction has not commenced, it is premature for
the proponents to conclude any agreements, if necessary at all, with the
concerned agencies, such as District Government Sukkur, Hyderabad
Electric Supply Company, Sui Southern Gas Limited, for provision of
connections and other services at the site, such as solid waste
disposal/water and sewerage, electricity and natural gas, respectively.
Such agreements or Memoranda of Understanding, if at all required, shall
be concluded by the proponents at the appropriate stage of the project
towards its completion. However, the proponents are being advised
through this environmental study to make all necessary arrangements
well in advance. All approvals shall be obtained well in time so that
construction remains unimpeded and so that the building can be colonised
and is available for operation as soon as the project is finalised. District
Government Sukkur, being the competent urban development authority
has accorded approval of building plans. Hyderabad Electric Supply
Company and Sui Southern Gas Limited shall be approached for approval
and sanction of electricity and gas connections.
Similarly, District Government Sukkur shall be approached for sanction
of water supply and sewer connections. Since activities at the proposed
building would be strictly medical in nature, water requirement would be
on the low side. Moreover, water storage has to be maintained for firefighting purposes and the capacity of the overhead water tank is around
40,000 gallons, which shall be constantly topped up by two existing tubewells. Telephone lines would be provided by local telephone companies.
The building plans cater for all utility connections in such a way that
there is no adverse environmental impact showing open drains, pipes and
external wiring. Since there are no trees at the project site that required
felling to facilitate construction, there shall not be any need to approach
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the concerned agency within the district administration to seek prior

permission for removal of trees. Finally, environmental approval shall be
obtained from Sindh Environmental Protection Agency in compliance of
legal requirements.
5.14 ECOLOGICALLY CRITICAL AND SENSITIVE AREAS
The proposed project shall be situated within a rural area that is being
brought under urban development. However, the project area is not a
catchment area of any river, stream, or nullah, despite proximity to River
Indus. The project site is plain without vegetation cover. There are no
trees within the project site. The project site is also not situated in an area
that is ecologically critical or sensitive in nature. There are no graveyards
or mosques or any shrines at the project site or nearby that can be affected
by project implementation or operation.
5.15 RESTORATION AND REHABILITATION
The building is designed as a hospital with substantial public dealing. In

order to ensure comfort of patients and visitors, the building will be
maintained according to the best health, sanitation, and structural
maintenance standards. The proponents anticipate that the building would
be used for a minimum of eighty to ninety years and has been designed
suitably to stand the test of the set time.
Mitigation: Constant maintenance, repairs and upgrading of the structure
would continue during operation of the hospital according to a carefully
prepared work schedule and would be adhered to religiously. However, at
the end of the life of the building, it will be dismantled as per municipal
procedures with special precautions to minimise if not totally avoid
pollution and at the same time taking every safety precaution to protect
life and property around the building. It is not possible of course at this
point of time to predict or anticipate the shape and form of the
surrounding areas when the building has lived its life and needs to be torn
down, either with wrecking balls or controlled explosion. Debris
generated from demolishing the building will be disposed in
environmentally sustainable fashion. Material capable of recycling or
reuse will be either sold or shall be reused in the next plan. While
dismantling the building, all building rules and regulations as applicable
to such an activity shall be observed strictly.
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It will be ensured that no damage is done to public infrastructure like

sewer system, power building, gas building, roads, and private or public
property. Complete safety measures, according to secured, safe and
effective norms of demolition, will be adopted to avoid harm to persons
engaged in the demolition, public property around the building or the
environment in the project area. Dust generated during demolition will be
minimised by constant sprinkling of water. After demolition, all
construction material, debris and garbage will be removed from the site
immediately and disposed as per procedures approved by municipal
regulations. Any minor spill over of such material will be cleared
adequately. Pitted ground will be adequately levelled, subject to further
use of the land. On the whole, the project site and the area in its near
vicinity will be made neat and clean for further use by the proponents or
successors-in-interest thereof.
5.16 PROPOSED SCHEDULE FOR IMPLEMENTATION
The project shall come into operation after twenty-four months of

commencement of construction. The proponents have engaged consultant
services to design the project, tender advice on structures, HVAC
(heating, ventilation and air-conditioning), mechanical and electric
components, landscaping, interiors, project management, and shall select
an experienced construction firm to execute the project. The project shall
be self-financing and the proponents have access to finances necessary to
complete the project within the targeted time schedules and there is thus
no question of construction being left abandoned during the tenure of the
project and thereby creating an environmental malaise at the site. Delays,
if any, would be due purely to unavoidable circumstances beyond human
control.
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DESCRIPTION OF THE ENVIRONMENT
This portion of the study describes environment of the project area. While
it discusses the physical environment in detail, it also touches upon other
important aspects of the local environment such as biological resources,
socio-economic development, quality of life values and cultural heritage,
so as to view the gamut of environmental parameters that can be affected
by any project.
6.1
ENVIRONMENTAL SETTING
Sukkur has been an important strategic centre and trading route from
times immemorial. The city of Sukkur lies on the right bank of River
Indus as an enclave that juts out west with borders on Shikarpur and
Khairpur districts. A greater part of the district is on the left bank and east
of the river as it flows south into Khairpur. Sukkur District covers an area
of 5,165 square kilometres. Geographically, it spans from 2705 to
2802 north latitudes and from 6847 to 6943 east longitudes. The city
of Sukkur is located at an altitude of 220 feet (67 metres) from sea level,
having terrestrial coordinates 6852 east and 2742 north. It is also the
narrowest point of the course of lower Indus River. Sukkur district shares
its northern border with Shikarpur and Jacoabad. Ghotki is located on the
north-eastern side while Khairpur is to the south and south-west. Indian
Rajasthan is towards the east of the district. A map of the district is at
Appendix X.
6.2
PHYSICAL RESOURCES
This section of the study examines physical resources, topography, soil,

climate, surface and ground water and geology of the project areas to
assess whether the project can impact on any of these parameters.
6.2.1 Geology and Geomorphology
Pakistan can be divided into five broad regions on the basis of physical
environment and geology, which are the Northern Mountainous Region,
the North-western Hills and Balochistan, the Sub-mountain Indus Region,
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the Indus Plain, and the Potohar Plateau and Salt Range. The Indus Plain
essentially forms the western extension of Indo-Gangetic Plain, and is
made up of silt brought by the Indus and its numerous tributaries, such as
Jhelum, Chenab, Ravi and Sutlej on the east bank, and Kabul, Kurram,
Tochi and other smaller rivers on the west bank. The project area is
located within this region, east of Ravi River. The Indus Plain covers an
area of about 200,000 square miles and is the countrys most prolific and
prosperous agricultural domain. It is an unrelieved featureless plain of
fertile alluvium extending for 650 to 700 miles from the rim of the
Potohar Plateau southward to the Arabian Sea. The quality of
groundwater in the Indus Plain varies, being mostly saline and unfit for
agricultural use in the south. Extensive areas in both the northern and
southern zones of the Indus Plain have been affected by water-logging
and salinity. District Sukkur lies in Northern Sindh within the southern
part of the vast Indus Plain. This plain was a result of filling of the
extensive geosynclines formed as a fore-deep due to upheaval of
Himalayan Mountains during the Tertiary Period. Initially submerged
under the sea, the depression was gradually filled up with detritus flowing
down Indus River and its tributaries, ultimately turning into a flat alluvial
plain. As the Indus Delta continued to advance south and the gradient of
the plain diminished gradually, the river shifted its course, frequently
swinging from east to west and vice versa, thereby giving rise to various
landforms.
6.2.2 Seismology
According to the seismic map of Pakistan at Appendix VIII and the

Pakistan Building Code Seismic Provisions 2007 (Appendix XI), the
project areas fall in Seismic Zone 2A, i.e. minor damage zone
corresponding to Intensity V and VI of the Modified Mercalli Intensity
Scale.1 Distant earthquakes with fundamental periods greater than 1.0
second may cause damage to structures in this zone. A moderate to high
intensity earthquake at the site can adversely impact on the development.
Foundations have been designed specifically to withstand any threat of
earthquakes that can be anticipated in the area considering its seismology.
6.2.3 Land Use
Prior to construction of Guddu Barrage, a large part of the district and

adjoining areas was under natural scrub forests, with cultivation confined
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to low-lying areas that received irrigation water from the river through
inundation canals flowing only when river water rose to high levels.
According to a study of the Soil Survey of Pakistan, Sukkur District
comprises 1,804,000 acres, out of which around one-eleventh of the area,
or about 165,000 acres, has a very high economic potential under
irrigation. Around one-fifth of the area, or 363,000 acres, consist of land
with a high economic potential under irrigation. One-fourth of the district,
or about 437,000 acres, comprises land with a moderate economic
potential. Land with poor economic potential under flood-watering
measures approximately 125,000 acres, whereas the remaining 714,000
acres consist of agriculturally unproductive land.
Agricultural areas across the river to the east of the city have restricted
cropping with perennial canal irrigation, restricted cropping with seasonal
flooding, and forests along the river. Landforms east of the river are
active floodplains comprising meander bars and levees, and level plains.
Away from the river, landforms are recent and sub-recent floodplains.
Land capability to the east is mainly good with some very good and
moderate irrigated land, predominantly moderate flood-watered land, and
mainly poor with some moderate flood-watered land. Shikarpur and
Khairpur districts lie to the west and south-west of Sukkur City. Land-use
in areas immediately close to the city have limited general cropping with
perennial canal irrigation, and restricted cropping with seasonal canal
irriation and little grazing. Land capability here is very good with some
good irrigated land, and good with some very good irrigated land.
Appendices XII, XIII and XIV show land-use, landforms and land
capability of areas to the east of the city whereas Appendices XV and
XVI show land-use and land capability of areas to the west of the city
in the Jacobabad area.
6.2.4 Hydrology
River Indus is the main factor controlling hydrology of the area, entering
the district near Kashmore at Guddu Barrage and runs along the entire
north-western boundary of the district. Prior to construction of barrages
and flood-protection embankments, the river used to sweep through
almost the entire district during high floods in the monsoon. Floodwater
flowed through the old river channels and low-lying areas, causing great
havoc at times. Finally, the water would converge in the south and escape
through a wide stream that is now the course of Nara Canal. Groundwater
table has been rising steadily due to seepage from canals in irrigated
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areas, fluctuating between 5 and 10 feet in Ghotki Feeder command, 8 to

15 feet in Nara Canal command, and 2 to 6 feet in Khairpur Feeder East
command areas. Water tables rise especially during the summer when
canals are at full discharge. Shallow groundwater in almost the whole of
irrigated area is of good quality and has salt content of less than 1,200
ppm. Good quality deep water is found in only about 40 percent of the
north-western part of the district while it is very poor in other parts, with
salt content of more than 2,500 ppm and as high as 4,500 ppm in other
places.
6.2.5 Water Table
Boreholes made at the project site for collection of soil samples

encountered water table at a depth of six feet.1
6.2.6 Soil
Soil along the river to the south and west of the city are typical of active
floodplains, mainly Sodhra Association and Shahdara Association.
Recent floodplains comprise soils with characteristics of Sodhra
Association, Shahdara Association and Shahdara-Miani Association. Subrecent floodplains with meander bars and levees are Jhakkar Association,
Kasur Association and Sodhra Complex. Soils in the level plains are
Pacca Association, Pacca-Dungi Association and Sultanpur Association.
Soils immediately to the west of the city in Shikarpur and Khairpur
districts are mainly Shikarpur, Miani, Pacca, Satghara and Jhakkar
associations. The project site is located within an area where the soil is
mainly Sodhra Series comprising mixed river alluvium, typical of active,
recent floodplains and uncovered bars in sub-recent floodplains.
Characteristics of this soil are shown at Appendix XVII.
Geotechnical investigation of the project site shows that the soil is
nodular limestone to a depth of seven metres, off-white to yellowish in
colour, very hard, moderately weathered, very fine grained texture, thinly
bedded with very close fracture spacing, slightly rough and filled.
Between seven to twelve metres, the soil is limestone off-white to
yellowish in colour, very hard, slightly weathered, very fine grained
texture, thickly bedded with very close fracture spacing, smooth and
stained. Soil from twelve to thirty metres consists of nodular limestone,
off-white to yellowish in colour, very hard, moderately weathered, very
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fine grained texture, thickly bedded with very close fracture spacing,
slightly rough an filled.1 Soils of Sukkur and Jacobabad districts are
shown at Appendices XVIII and XIX.
6.2.7 Topography
The proposed project site is a part of a fast-developing rural area to the

north-west of the city of Sukkur at 274210.72 north latitude and
685006.53 east longitude, with elevation of fifty-eight metres above
sea level. Topography of the entire project area as a whole is uniform and
generally common to most of the local floodplain. A topographical
illustration of the project site is placed at Appendix IV.
6.2.8 Climate
Pakistans latitudinal and longitudinal extents and its northern rim of lofty
mountains are the two factors having great bearing not only on
temperature and rainfall patterns, but also on general circulation of
atmosphere in South Asia. As per widely-used climate classification
system developed by Wladimir Kppen, Pakistan has five types of
climate. The first type is tropical semi-arid with dry winter, which
prevails in the former Karachi, Hyderabad and southern Khairpur
divisions. Tropical arid climate characterised by dry winters is
experienced in southern Kalat and the whole of the Indus Plain. The Cold
Semi-arid with Dry Summer climate type prevails over Central Kashmir,
Peshawar, Dera Ismail Khan, Quetta and northern half of the former
Kalat Division. Snow Forest Climate covers the northern mountainous
areas and parts of Kashmir. Finally, Extreme Cold climate is experienced
in eastern and northern parts of Kashmir, Chitral and Northern Areas. The
project areas fall in the arid, subtropical continental climate zone. Low
rainfall, low relative humidity, high evaporation, great fluctuations in
temperature and occasional windstorms are salient features of the local
climate.
6.2.9 Seasons
There are four well-marked seasons in the country. The cold season
(December to March) is influenced by frequent passing of western
disturbances originating over the Mediterranean and Western Europe.
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These cyclones advance eastward over Saudi Arabia, Iran, Afghanistan

and then to Pakistan. Mean monthly temperature is below 4.4C in
mountainous areas, and varies from about 10C in the north of the plains
to about 18C in south. Rainfall during this period increases northwards
and westwards. The hot season (April to June) sees high temperatures and
aridity. Day temperature begins to rise and peaks in June from 40C to
46C, while temperatures of 50C and above are not uncommon. The
monsoon season (July to September) is caused by low pressure over the
Indo-Pakistan subcontinent in May and June, attracting winds from the
Indian Ocean, which start blowing over the land about middle of June, as
the south-west monsoons. Changes in the structure of the upper air during
this season allow further invasion of moist air from the Bay of Bengal in
July. This period experiences periods of heavy rains and storms. The
monsoon spreads northwards, generally in a series of pulses. It reaches
the Punjab by early or mid-July. The monsoon currents remain steady in
July, mostly constant to the middle of August, and begin to recede at the
end of August. The post-monsoon season (October and November) is
basically transitory. October and November are by far the driest months
on account of anti-cyclonic conditions, and are characterised by clear
skies, and light and variable winds all over the plains of Pakistan. The
project area experiences four seasons, i.e. summer, winter, autumn and
spring, with a short monsoon.
6.2.10 Rainfall
There are two sources of rainfall in Pakistan, i.e. the Monsoon and the
Western Depression. The former takes place from July to September
while the latter occurs between December and March. The major part of
the province of Punjab receives less than 250 mm of rainfall in a year.
Southern Punjab receives less than 125 mm of rainfall and as such mostly
falls in an arid zone. True humid conditions appear after the rainfall
increases to 750 mm in plains and 625 mm in the highlands. Average
rainfall of the district is 88 mm, and ranges from 0.59 mm to 25.62 mm
per month. Annual average for the last ten years is shown in Table 32.
6.2.11 Humidity
Relative humidity in Sukkur at 0800 hours is below 54 percent during

April and 77 percent in the monsoon season. Average monthly relative
humidity values are shown in Table 33 following this chapter.
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6.2.12 Monthly Mean Temperatures
The thermal equator, which is the line of the greatest mean heat of the
globe, passes through Sindh. The mean annual temperature is about 80 F,
while the mean summer (May to July) temperature being 94 F. The mean
winter (December to February) temperature is about 62.1 F. Variations
in temperature, both diurnal and seasonal, are great. June is the hottest
month with a mean maximum temperature of about 109 F, while January
is the coldest month with a mean minimum temperature of about 45 F.
Mean annual evaporation is 1,918 mm. Monthly mean minimum and
maximum temperatures (C) during 2001-2010 are shown in Tables 34
and 35 at the end of this chapter.
6.2.13 Wind Direction and Speed
The dominant wind direction in the area is south and south-east in

summer. Light and hot wind, which is a weak extension of the south-west
wind arising from the sea coast, blows for a part of the year during the
summer. Light northerly winds predominate during the winter. Wind
speeds can reach a maximum of 2.2 knots during the summer and be as
low as 0.2 knots during the winter. Tables 36 and 37 show wind direction
and speed for the project area over 2001-2010.
6.2.14 Visibility
Visibility remains good throughout the year except for December and
January, when patches of fog can be disruptive for traffic. There is mild
urban smog that is visible at dawn while industrial smog is minimal.
6.2.15 Surface and Groundwater Resources
Groundwater is found in a very large area under the crust of the earth and
the total estimated amount is about 500,000 million acre feet, out of
which one-fifth lies within a depth of 2,500 feet from the surface. This is
more than thirty times the water contained in all fresh water lakes and
more than 3,000 times the average volume of water flowing through
rivers and streams.1 Pakistan has extensive groundwater resources built
up over the millennia through direct recharge from natural precipitation,
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river flows, and in recent times from continuous seepage from

conveyance systems of canals, distributaries, watercourses and
application losses in irrigated lands. Out of the total groundwater
potential of fifty-five million acre feet, about 49 million acre feet will be
exploited presently.1 Pakistan can be divided into five major zones for
drinking water sources, which are as follows:
Sweet groundwater areas, where water is easily accessible for
human consumption;
Brackish groundwater areas, where canal or river water is
available;
Mountainous and hilly areas in the north, where spring water
is largely abundant;
Eastern desert belt, where groundwater may be available only
at greater depth, and
Coastal belt, where saline water is generally available.
Sukkur District generally falls in the sweet groundwater classification.
There are no streams running through the project area that can be affected
by project activities. A large volume of underground water is available
throughout the project area, which is by and large fit for human
consumption. There is also no wetland in the near vicinity of the project
site. Municipal water supply is quite extensive but tube-wells have been
sunk on need basis to meet additional water needs.
6.2.16 Surface and Groundwater Quality
The quality of groundwater is area specific and generally ranges from

fresh with Total Dissolved Solids (TDS) less than 1,200 ppm near the
river to highly saline with salinity exceeding 4,500 ppm. A paper released
by Pakistan Environmental Protection Agency states that groundwater
quality in urban centres is affected the most by wastewater. According to
an estimate some years ago, two million tons of human excreta was
produced in 2004, out of which at least fifty percent ended up in water,
basically because areas covered by sewerage networks is extremely low.2
Groundwater in the project area is normally available at a depth ranging
between 20 to 50 metres below natural surface level. Readings of water
quality at various locations in Sukkur are at Appendix XX. Out of
twelve sources of drinking water collected from the city by the Pakistan
Council for Research in Water Resources, only one was found safe for
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direct human consumption.1 The National Drinking Water Policy2 of the

federal government envisages implementation of drinking water quality
standards after these are developed by the Government in line with World
Health Organisation Guidelines and approved by the Federal Cabinet.
These standards shall apply both to rural as well as urban water supply
schemes and were officially released in June 2008.3 As stated in the
previous section, there is ample sub-surface water available throughout
the project area.
Mitigation: Groundwater samples were collected from a borehole at the
project site and analyses were carried out at the Central Research
Laboratory of the Public Health Engineering Department. The results are
presented in Table 38. Laboratory tests have ascertained that groundwater
at the project site is fit for direct human consumption (Appendix XXI).
6.2.17 Soil Contamination
No visible signs of soil contamination were observed during site visits. It

has been ascertained through interviews with geologists that
concentrations of sulphates in the project area are well within permissible
limits. However, sulphate resistant cement has been advised for all
construction activities due to the high water table.
6.2.18 Present State of the Habitat
The project site and immediate environs are primarily semi-urban to rural
in nature and there are no breeding or nesting grounds, or a wetland or an
ecologically critical area in the near vicinity that can be affected
adversely by project implementation or operation of the medical facility.
6.2.19 Ambient Air Quality
Pakistans Strategic Country Environmental Assessment concludes that

environmental degradation is estimated at 6 percent of the Gross National
Product and the cost to the economy in terms of air pollution has been
calculated at Rs. 65 billion per year.4 According to a position paper of the
Pakistan Environmental Protection Agency, air pollution is an emerging
environmental issue in the larger cities, due mainly to high growth rate of
the economy, urbanisation, growth of infrastructure and an increase of
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almost four hundred percent in the number of vehicles.1 Experts consider

that vehicles account for sixty to seventy percent of degradation of air
quality in urban areas.2 Table 13 below indicates increase in registered
motor vehicles during the period 1990 to 2010.
TABLE 13: REGISTRATION OF VEHICLES (PAKISTAN)
Year
1990
1995
2000
2005
2007
2009
2010
2011 (Consultantsestimate)
No. of Registered Vehicles

2,712,837
3,669,948
4,701,596
5,374,429
5,907,813
6,559,364
7,853,022
9,109,505
Source: Pakistan Economic Survey 2010-11
This huge increase of almost three hundred percent during the last
seventeen years or so has resulted in deterioration of ambient air quality,
especially in fast-growing urban centres and along major highways
elsewhere. Vehicular emissions are, however, not the main source of
adverse impact on ambient air quality. No studies have been conducted
regarding ambient air quality in Sukkur District. However, ambient air in
the project area is affected by emissions from motor vehicles, and to a
lesser extent by industry and brick kilns. A study funded by the Japanese
International Cooperation Agency in 2000, which remains the most
authentic ambient air quality survey for urban areas, reveals that
particulate matter is the main problem surrounding ambient air quality.3
Suspended Particulate Matter (both TSP and PM 10 ) concentrations in all
major cities are extremely high. Major sources of Suspended Particulate
Matter, not especially in the project area, are vehicles, industry, burning
of solid waste, brick kilns and natural dust. The origin of Suspended
Particulate Matter is mainly from unpaved roads and areas not covered
with grass or plantation. Accordingly, fine particles of soil are raised in
the form of dust cloud by driven vehicles and by strong wind. The second
air pollutants are nitrogen and nitrogen oxide, occurring mainly due to
combustion of fossil fuels, particularly boilers and furnaces in industry.4
The city does not suffer from high SO 2 and SO 3 emissions, which are
prevalent in urban areas largely due to use of coal and heavy oil in
industry as well as dwellings. The presence of some SO 2 emissions has
been attributed to diesel-powered engines in vehicles. Carbon Monoxide
in the air occurs due to incomplete combustion of fuel, the major source
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being motor emissions. Carbon Monoxide emissions in Sukkur are much

lower as compared to major cities, basically due to lesser number of
vehicles.
6.3
ECOLOGICAL RESOURCES
As the project site fall in the urban area, factors such as ecological
resources, fisheries, aquatic biology, wildlife, forests, rare or endangered
species are not applicable and the proposed project will have no impact
on any of these resources. Similarly, urbanisation and steady erosion of
rakhs along the river, which once teemed with wildlife, particularly wild
boar and rabbits and various species of migratory birds, has almost totally
eliminated wildlife from the environs.
6.3.1 Flora
Not much of original vegetation has survived in the district after

construction of Guddu Barrage and increase in the canal command areas.
In the riverine belt, the main tress are Prosopis spicigera (jandi),
Salvadora Oleoides (wan), Capparis aphylla (karir), Tamarix articulata
(farrash), Acacia Arabica (kikar) and Zizyphus jujuba (berry). The main
shrubs are Tamarix diocca (lai), Alhagi camelorum (jawan), Perganum
harmala (harmal) and Calotropis Procera (ak), whereas the main grasses
are Cynodon dactylon (khabbal), Desmostachya bipinnata (dab) and
Saccharum munja (sarkanda). Tamarix diocca (lai) is the typical natural
vegetation of strongly saline gypsiferous soils. Dalbergia sissoo
(shisham), Azadiracchta indica (neem), Albezia labek (siris) and Acacia
Arabica (kikar) are the planted trees along canals, roads and around
habitations in canal-irrigated areas. Main fruit trees include mango and
dates, but pomegranates, lime, plantains, apples and fig are also grown in
some areas, especially within protected orchards. Clover is grown in
small quantities during winter.
6.3.2 Fauna
Much of the districts fauna has been reduced due to cultivation and
human activity, but there are still traces of wolves, wild boar and snakes
along the river. Desert areas to the east of the district, which are protected
under the relevant laws relating to preservation of wildlife, have an
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abundance of deer and migratory birds. It is expected that land

development in the suburbs shall have additional impact on fauna.
6.3.3 Threats to Flora and Fauna
No flora or fauna shall be under threat from project activities. Both flora
and fauna stand reduced in the project area due to urban development.
6.4
SOCIO-ECONOMIC ENVIRONMENT
The close relationship between social and environmental systems makes

it imperative that social impacts are identified, predicted and evaluated in
conjunction with bio-physical impacts during environmental assessment.
People and their social groups are a component part of their environment,
and environmental changes are often linked to social change, and vice
versa. Social impacts include changes that effect individuals, institutions,
communities and larger social systems as well as the interactions between
them. In basic terms, they are alterations in the way people live, work,
play, relate to one another and organize to meet their needs, as well as
changes in the values, beliefs and norms that characterize their group
and guide individual and collective action. Social impacts can broadly be
classified as:
Demographic impacts, such as changes in population numbers,
population characteristics (gender ratio, age structure, demand
for social services);
Cultural resource impacts, such as individual changes in
archaeological, historical and cultural artefacts and structures
and environmental features with religious or ritual significance,
and
Socio-cultural impacts, including changes in social structures,
social organizations, social relationships and accompanying
cultural and value systems (language, dress, religious beliefs
and rituals).
6.4.1 Demography
The population of Sukkur District is an estimated 1.277 million as of end

of December 2010, with urban population comprising about 50.88
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percent of the total. High growth of population in Sukkur is typical of

urban centres of the country and is due mainly to rural-urban migration
and industrial and commercial growth over the last ten years or so.
Growth of population in the province and Sukkur are shown below.
TABLE 14: POPULATION (000 persons)
Sindh
Sukkur
1998
30.44
0.91
2005
36.93
1.108
2010
42.40
1.28
Growth rate
2.80
2.88
Source: Development Statistics of Sindh 2008
6.4.2 Education
Educational facilities in Sukkur at primary to degree levels of education

indicating enrolment of girls and boys and strength of teaching staff is
shown in Tables 15 to 17 overleaf, along with technical education
institutions within the district as compared to the province as a whole.
There are both private and public sector schools, colleges and universities
in the city, as shown at Appendix XXII.
6.4.3 Public Health
Health impacts can result directly from changes to the bio-physical

environment (such as exposure to toxic pollution) or indirectly as the
result of other changes caused by the project (for example, lowered socioeconomic status leading to increased morbidity and mortality). As stated
earlier, the nature of the project does not have any relevance to health
facilities within the district either but these will be addressed in
compliance of the prescribed guidelines. Due to urban nature of the
project area, there is a good coverage of government hospitals. Residents
of the project areas generally depend on private hospitals and dispensaries
for their health and medicinal needs. Medical facilities in the district as
compared to the province as a whole are shown in Tables 18 and 19
overleaf.
6.4.4 Power Sources and Transmission
Hyderabad Electric Supply Company is the agency responsible for supply

of power to the project areas and upgrades its facilities frequently so as to
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readily meet the rising demand for power connections. Commercial and
industrial establishments using natural gas for various purposes have
ready access to supply of gas from the country-wide gas network
maintained by Sui Southern. Areas not connected with the natural gas
network use cylindered liquefied petroleum gas, which is available
throughout the district. Connections are readily available for domestic
and commercial consumers. Other forms of power such as cylinder gas,
propane, timber and coal are similarly easily available in and around the
project area.
6.4.5 Infrastructure
Being the major northern city of the province, Sukkur has substantial
coverage of civic infrastructure. Water supply and drainage services are
provided by the Town Municipal Administration. Apart from outlying
areas of the city, coverage of water supply and sanitation is more than
adequate. The entire city is well-connected through electricity and natural
gas, provided by Hyderabad Electric Supply Company and Sui Southern
Gas Company, respectively. Telephone companies have a vast network of
telephone lines and connections are easily available. Areas not covered
by telephone network can apply for wireless connections that are offered
extensively. The entire city is well-covered in terms of mobile telephone
facility and as many as five major cellular companies compete for
consumer patronage. The project area has an adequate service of Internet
Cafs. Construction of the proposed hospital shall not impact on the
existing infrastructure.
6.4.6 Road Network
Sukkur city has a good network of roads, which is continuously upgraded

to cater for increasing traffic. Table 20 indicates roads in the project area,
which does not include all types of roads within the urban area of Sukkur
city.
TABLE 20: ROADS
TYPE OF ROADS (in kilometres)

High Type (2007-08)
Low Type (2005-06)
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Sindh
10,609
2,947
Sukkur
267
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6.4.7 Transportation
The city can claim to enjoy availability of the main rail links and
highways connecting with the rest of the country, and an airport handling
domestic traffic. The project area is in the heart of the administrative
centre of the city and there is ample public transportation in the form of
buses, wagons, taxis and rickshaws. The following table indicates
transportation levels in the district.
TABLE 21: REGISTRATION OF VEHICLES
Year
1990
1995
2000
2005
2007
2008
2009
2010
No. of Registered Vehicles

(Pakistan)
2,712,837
3,669,948
4,701,596
5,479,417
5,987,729
6,286,267
6,435,538
6,757,315
No. of Registered
Vehicles
(Sindh)
------1,992,465
2,232,267
-------
No. of On-Road
Vehicles
(Sukkur)
--------46,215
-------
Source: Pakistan Economic Survey 2009-10, Development Statistics of Sindh 2008
6.4.8 Industries
Although there are no large industrial units within the city or immediately
across the river, Sukkur District is a hub of many small and large-scale
industries, employing a sizable number of workers. Among important
industries are cotton textiles, cement, leather, tobacco, paint and varnish,
pharmaceuticals, agriculture implements, hand pumps, lock making, ricehusking, fertiliser and sugar. Small-scale cottage industries comprise
hosiery, boat making, fishing accessories, thread ball spooling, trunk
making, brass-wares, cutlery and ceramics. Major industrial units are
located in Dharki and Mirpur Mothello. The following table provides an
illustration of factories and workers in the district.
TABLE 22: FACTORIES AND WORKERS (2005-06)
Sindh
Sukkur
80
Factories (number)
1,825
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Workers (number)
290,376
11,786
10/2011
6.4.9 Livestock
The district has a large population of livestock, serving meat and dairy
needs of the public. Major livestock in the project area are indicated in
Table 23 whereas Table 24 shows availability of veterinary facilities in
the district.
TABLE 23: LIVESTOCK (number in thousands in 2000)
Sindh
5,464
5,615
3,710
9,734
11,861
Cattle
Buffaloes
Sheep
Goats
Poultry
Sukkur
209
171
56
272
418
TABLE 24: VETERINARY FACILITIES (2006-07)

Sindh
119
60
608
787
Hospitals
Dispensaries
Veterinary Centres
TOTAL:
Sukkur
9
7
30
46
Table 25 gives an illustration of fish production, employment and boats.

TABLE 25: FISHERIES (2007)
TYPE:
Fish production (metric tons)
Part-time fishermen
Full-time fishermen
Total number of fishermen
Sailboats
Rowing boats
Total number of boats
Sindh
94,790
19,258
31,767
51,025
1,002
2,465
3,467
Sukkur
3,975
795
2,060
2,855
89
80
169
6.4.10 Forests
Sukkur also has a large riverine forest along the course of the Indus.
These tropical forests are found within the protective embankments on
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either side of the Indus. During 1997-98, total area under forests was
510 square kilometres, yielding 55,000 cubic feet (1,600 m3) of timber
and 27,000 cubic feet (760 m3) of firewood besides other products. Most
of the linear plantation is along the irrigation channels and does not
include massive linear plantation taken up by the provincial government
and municipal authorities during the recent past along roads and
highways.
TABLE 26: FORESTS (2006-07)
TYPE:
Area under forests (in hectares)
Timber production (quantity)
Firewood production (quantity)
Sindh
1,037,571
2,386,239
1,219,946
Sukkur
34,383
165,442
177,431
6.4.11 Agriculture
Sukkur District had a large fertile and cultivable land area until a few
decades ago, when Indus River was more as free-flowing as today.
Agricultural productivity has declined over the years, and has not
achieved a reasonable yield per unit area over time, on account of
continuous shortages of water and non-application of modern irrigation
techniques. Despite the lack of water during kharif, rice, bajra, cotton,
tomatoes and peas are cultivated widely, whereas the main crops during
rabi are wheat, barley, grams and melons. Sukkur is famous the world
over for its delicious dates. Tables 27 to 31 overleaf are an agricultural
profile of the project areas.
6.4.12 Irrigation and Drainage
Sukkur and adjoining districts have one of the most extensive irrigation
networks in the country. Sukkur Barrage, formally called Lloyd Barrage,
built during colonial times on Indus River, has sixty-six gates and
controls one of the largest irrigation systems in the world. Construction of
the bridge was started in 1923 and completed in January 1932. The
5,001 feet (1,524 metres) long barrage is made of yellow stone and steel
and can water nearly 10 million acres (40,000 square kilometres) of
farmland through its seven large canals. Some of the canals are larger
than the Suez Canal. In November 2004, the Government of Pakistan
initiated a rehabilitation project to revitalise its water storage capacity and
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distribution efficiency. The project was completed in July 2005. Experts

believe that rehabilitation of the barrage has enhanced its efficiency for
another 60 to 70 years.
6.4.13 Land Use Planning
The project site is situated close to an urban centre, which is overseen by

the Town Municipal Administration for purposes of land-use planning,
building regulations and municipal services.
6.4.14 Mineral Development
There is no mineral development of note anywhere in Sukkur or close to

the project area except for sand quarrying on River Indus riverbed.
6.5
QUALITY OF LIFE VALUES
Guidelines prescribed by the federal government for preparation of an

environmental report stipulate that an environmental study must also
address issues relating to socio-economic, cultural and aesthetic values of
the community in project areas.
6.5.1 Cultural Values
Original residents of the project area belong to the rural lower to middle
class. They follow a blend of old and modern cultural values. However,
the younger generation is inclined to be somewhat modern and influenced
by western culture. The joint family system is still common and there is
respect for the destitute, the elderly and women.
6.5.2 Socio-economic Values
A majority of residents of the area belong to the lower to middle income

rural class, with some landed aristocracy. Social values of residents are
not too far removed from the majority of the countrys population. There
is sufficient awareness about education and most families send their
children to educational institutions. Despite living close to an urban
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environment, people come into intimate and direct contact with each
other and, therefore, they share common social and economic values of
life. There is general harmony towards collective interests amongst the
local people. The poor generally rely on the affluent for support and to
some extent to the social safety nets of the government.
6.5.3 Aesthetic Values
Being close to a large urban centre, the entire project area cannot claim
aesthetic values except in the form of open spaces under cultivation,
providing exquisite rural scenery. Generally speaking, cleanliness and
proper sanitation standards are typical of rural areas. Throwing away
solid wastes indiscriminately in open areas and along the roads and paths
is common. Sense of personal responsibility as good citizens to keep the
environment clean is seriously deficient and public awareness campaigns
launched by the government and municipal authorities have largely failed
to motivate the public to adopt the best civic practices and recognise civic
responsibilities. People expect others to maintain cleanliness of the
surroundings, while shrugging their personal as well as collective social
responsibility and obligation in this respect. Resultantly, waste-ridden
areas remain dirty and vectors of diseases like mosquitoes and flies breed
on solid waste lying almost unattended. These vectors further spread a
host of diseases among the people. Even dogs, cats and rats are often
found scavenging around the solid waste for sources of food. A wellcoordinated public awareness campaign backed by the civil society and
environmental education, especially in the educational institutions, is
perhaps the only mechanism whereby the public can be made fully
cognisant of the value of cleanliness of public places.
6.5.4 Recreation and Archaeological/Historical Treasures
There are virtually no recreational facilities in the project area, except for
a few open fields that are used by youngsters for cricket, football and
volleyball. However, the city and outlying areas are rich in sightseeing
venues such as Indus River, Manzilgah Mosque at Bundar Road, Sadh
Belo Temple on River Indus, Tomb of the Seven Maidens --- Sateen Jo
Aastan (resting place for the Seven Female Friends), War Mubarak
Mohammad in Rohri City, Aror (ruins of historical city), Shrine of Syed
Sadar-Ur-Din-Shah, Tomb of Shah Khairuddin Jillani, Kot Mir Yakoob
Ali Shah Rohri, Tomb of Abdul Baqi Purani, Ex-Governor of Bukkur,
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Bukkur Island, Tomb of Syed Hakim Ali, Minaret of Masum Shah,

Lansdowne Bridge, Sukkur Barrage, Ladies and Children Hill Park,
Jinaat (Genies) Building, Old Sukkur, Hyderi Masjid, Old Sukkur, and
the Tomb of Syed Mukhdoom Shah Badshah,
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TABLE 32: RAINFALL (MM) [-1=TRACE]

-------------------------------------------------------------------------------------------------------------------JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
-------------------------------------------------------------------------------------------------------------------2001
0.0
2002
0.0
2003
2.1
2004
0.7
2005
-1
2006
0.0
2007
0.0
2008
3.0
2009 10.6
2010
1.0
0.0
0.0
8.5
0.0
12.7
0.0
44.7
1.0
0.0
6.0
0.0
6.6
-1
0.0
17.0
10.6
6.4
0.0
13.0
-1.0
31.0
-1
0.0
-1
0.0
0.0
7.7
11.0
0.0
1.0
0.0
0.0
0.0
0.0
6.0
0.0
0.0
17.5
0.0
0.0
4.0
-1
-1
19.0
5.0
0.0
19.8
0.0
0.0
13.0
77.0
2.0 0.0
0.0
0.0 0.0
117.6
3.2 0.0
-1
-1
-1
30.5
0.0
-1
0.0
9.0 0.0
5.8 15.0 0.0
0.0 130.0 16.0
3.1
0.0 0.0
-1.0 67.0 0.0
0.0
0.0
0.0
2.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
-1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
-1
-1
0.0
7.6
0.0
10.5
0.0
114.2
1.0
0.0
-------------------------------------------------------------------------------------------------------------------Source: Pakistan Meteorological Department, Islamabad
TABLE 33: HUMIDITY AT 5.00 P.M. (%)

-------------------------------------------------------------------------------------------------------------------2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
83.0
82.0
85.0
87.0
86.0
81.0
82.0
84.0
92.0
73.0
74.0
75.0
79.0
84.0
81.0
83.0
85.0
74.0
84.0
73.0
70.0
74.0
71.0
73.0
80.0
79.0
82.0
73.0
79.0
66.0
65.0
55.0
61.0
56.0
59.0
59.0
68.0
68.0
61.0
47.0
65.0
51.0
55.0
56.0
57.0
65.0
67.0
67.0
59.0
47.0
68.0
70.0
69.0
63.0
69.0
68.0
71.0
72.0
67.0
53.0
79.0
77.0
83.0
74.0
75.0
73.0
78.0
75.0
74.0
65.0
80.0
78.0
81.0
79.0
77.0
81.0
81.0
84.0
76.0
77.0
84.0
82.0
84.0
82.0
82.0
87.0
84.0
84.0
86.0
72.0
87.0
87.0
85.0
79.0
83.0
84.0
82.0
84.0
84.0
72.0
84.0
86.0
82.0
84.0
82.0
86.0
87.0
81.0
83.0
71.0
86.0
83.0
85.0
84.0
85.0
89.0
84.0
91.0
86.0
80.0
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TABLE 34: MONTHLY MEAN MINIMUM TEMPERATURES ( C)

-------------------------------------------------------------------------------------------------------------------2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
5.6
6.1
--7.4
6.4
6.8
6.9
5.8
10.2
9.9
8.7
8.1
--10.0
10.0
14.1
12.6
7.4
12.8
2.1
14.0
15.1
--15.4
16.6
16.6
16.0
16.7
16.9
20.2
20.5
21.8
--23.2
19.3
21.7
22.7
21.5
20.9
25.9
27.3
26.5
24.7
26.7
24.7
27.5
25.9
26.9
26.9
29.7
28.9
--28.7
29.3
28.4
28.6
29.2
29.2
27.5
29.7
27.6
--28.5
27.9
28.7
29.8
29.1
28.5
29.2
30.6
26.7
--28.2
27.7
27.5
28.0
28.2
27.0
28.1
28.7
22.6
--24.7
24.3
26.0
26.1
26.1
25.3
25.2
27.3
16.7
--17.8
19.0
19.7
22.4
17.7
21.8
18.0
23.9
10.5
--10.6
13.1
14.8
15.7
14.5
13.4
13.1
16.0
9.4
--7.2
9.3
6.9
9.6
7.3
10.8
9.5
9.1
TABLE 35: MONTHLY MEAN MAXIMUM TEMPERATURES ( C)

-------------------------------------------------------------------------------------------------------------------2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
24.1
24.1
24.6
22.9
--22.6
23.0
20.4
21.3
28.8
27.6
26.1
26.0
27.7
22.6
29.4
26.0
25.6
26.3
26.5
33.0
33.3
32.2
36.3
30.8
31.8
30.5
35.1
31.5
35.8
38.3
40.0
39.6
41.0
37.6
39.5
40.4
38.0
37.5
41.4
44.6
45.3
42.8
43.7
41.5
44.0
42.8
42.9
44.2
44.6
43.1
45.0
45.1
44.3
43.7
42.9
42.2
41.8
42.2
42.9
39.6
42.5
38.8
42.0
40.5
42.2
40.7
40.7
41.8
40.5
39.1
40.0
38.7
40.3
39.5
37.8
40.0
38.0
39.9
35.9
38.5
38.9
37.5
38.3
37.7
38.0
35.1
37.1
38.4
37.4
36.1
36.4
35.6
33.8
36.1
36.2
35.5
36.7
35.0
37.6
31.6
31.0
29.3
---30.4
30.1
32.3
30.6
29.5
29.5
26.8
25.8
25.1
---25.3
23.3
23.8
23.1
24.8
23.5
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TABLE 36: WIND DIRECTION AT 0500 A.M.

---------------------------------------------------------------------------------------------------------------------JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
---------------------------------------------------------------------------------------------------------------------2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
N68E
N40E
N72E
N38E
E
N63E
N63E
N40E
N19E
N40E
N56E
N73E
N66E
N72E
N51E
N63E
N72E
N34E
N34E
N73E
N36E
S84E
N18E
S80E
N75E
S82E
N86E
E
N59E
S84E
N84E
S27E
S49E
N42E
S86E
S63E
S56E
N39E
N63E
S27E
S19W
S45E
S40E
N27E
S31E
S15E
S20E
S59E
S67E
S45E
S28E
S11E
S08E
S13E
S1E
S25E
S34E
S8E
E
S11E
S24E
S16E
S45E
S06E
S12E
S24E
S16E
S30E
S69E
S16E
S21E
S07E
S8E
S16E
S7E
S72E
S22E
S18E
S24E
S07E
S27E
S35E
S25E
S23E
S63E
S56E
S45E
S76E
S27E
S35E
S82E
S69E
N88E
N77E
S41E
S72E
N
S56E
E
S69E
N76E
N32E
N63E
S86E
N83E
N72E
S82E
N67E
S45E
N32E
N59E
N72E
N72E
N34E
N45E
N18E
N19E
N27E
N34E
N72E
---------------------------------------------------------------------------------------------------------------------Source: Pakistan Meteorological Department, Islamabad
TABLE 37: WIND SPEED AT 0500 A.M. (KNOTS)

-------------------------------------------------------------------------------------------------------------------2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
1.2
1.2
1.4
1.3
0.6
1.1
1.0
1.7
0.2
1.3
1.1
3.2
2.7
1.1
1.8
1.6
2.4
1.3
0.7
2.5
1.6
2.6
3.3
2.7
2.7
3.2
2.0
1.3
1.0
3.1
2.4
4.7
3.1
4.5
2.9
4.0
2.6
1.3
1.3
3.0
3.2
6.2
3.5
6.6
4.0
5.4
3.0
1.2
1.9
3.4
5.6
9.0
6.1
5.3
4.2
4.5
5.9
3.6
1.9
6.2
3.5
8.5
3.9
5.9
0.6
4.6
3.6
0.6
2.2
3.7
3.4
6.1
3.3
4.0
0.5
2.6
3.2
1.0
2.1
3.6
1.8
4.4
4.0
3.0
4.3
1.7
1.5
0.7
0.7
4.2
0.9
2.1
1.5
2.0
0.2
1.0
0.3
0.6
0.2
1.5
0.9
1.6
2.1
1.3
1.3
1.1
0.9
0.3
0.4
2.4
1.0
1.2
0.5
0.6
0.0
1.1
0.1
1.2
0.3
0.8
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TABLE 38: GROUNDWATER QUALITY
Parameters
Temperature
pH
Odour
Colour (units)
Taste
Turbidity ppm Silica (units)
WHO Desirable levels

WHO Maximum levels
--7-8.5
6.5-9.2
Unobjectionable
5
50
Unobjectionable
5
25
Sample
32C
7.1
Unobjectionable
Colourless
Unobjectionable
1.1
500
Total Dissolved Solids
Calcium (Units)
Magnesium
Total hardness mg/l as

CaCo 3
Total Alkalinity mg/l as
CaCo 3
Sulphate
Chloride
Conductivity um/cm or
us/cm
1,500
75
200
50
150
100
1,477
24
13
500
110
--200
400
200
600
340
---
2,110
284
255
Source: Tests at the Central Research Laboratory, PHED Department, Government of the Punjab,
Lahore, on September 13, 2011
Samples taken on September 09, 2011 at 1345 hours from project site
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Environmental impact of a project is worked out using various factors, so

that an environmental management plan can be evolved to take mitigation
measures. Paul Wathern describes an impact as having both spatial and
temporal impacts, which can be described as the change in an
environmental parameter over a specified period and within a defined
area, resulting from a particular activity compared with the situation
which would have occurred had the activity not been initiated.1 Aspects
of impacts which should be considered while conducting an
environmental impact are shown overleaf. Environmental impacts
described in Table 39, which apply to more or less all cases of project
implementation across the board, can be classified as follows:
Nature: The most obvious impacts are those that directly relate
to the proposal (for instance loss of wetlands, relocation of
households, increased air emissions). Indirect impacts are
usually less obvious, occurring at a later stage or at a place other
than where the original impacts occurred (for example, spread
of malaria as a result of removal of trees or accumulation of
stagnant waste water in ponds, pesticides in the breast milk of
mothers due to the use of agricultural pesticides, environmental
degradation of a river mouth resulting from construction of a
high dam within the catchment area, and resulting reduction in
environmental flows);
Magnitude: While the sheer size of an impact contributes to its
significance, small impacts can sometimes be equally important
(very small quantities of some toxic substances can cause largescale health problems for all forms of living things);
Extent and Location: An indication of the location,
distribution and size of the area(s) likely to be affected must be
considered for each impact, whether direct or indirect;
Timing: Impacts from all stages of the life of the project has to
be considered (during construction, operation and
decommissioning), as some impacts occur immediately whereas
other may be delayed, at times for many years (silting of a
dam);
Duration: Some impacts may be short-term, such as noise
arising from equipment during construction, while others may
be long-term, such as inundation of land after a dam is
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completed. Impacts such as quarry blasting may be intermittent,

while others such as severance caused by a motorway may be
more or less permanent and/or continuous;
Reversibility: Once the cause of an environmental impact has
been removed, it may be that the pre-existing environmental
condition can be more or less restored to its original state. If
impacts are reversible, either naturally or with human
intervention, restoration is then much easier. However, some
impacts by the nature of a project are irreversible, and
Likelihood (Risk): Not all impacts share the same likelihood of
occurrence. Some can be predicted to occur, more or less
definitely, while others are less certain (but still capable of
probabilistic estimation --- release for example of a toxic gas
from a chemical plant). In all cases, some estimate has to be
made of the uncertainty or margin of error involved in the
prediction. It is, therefore, important that impact assessment
considers the effects of events that are low risk but high impact
(such as oil spills, accidents of tankers carrying chemicals).
7.1
IMPACT ASSESSMENT METHODOLOGY
After identification of potential issues, impact assessment of each

potential issue takes the form as described hereafter in the following subsections.
7.1.1 Definition of the Criteria for Determining Significance
Consequences of the proposed project activities are evaluated by

comparing these against established criteria, such as:
Institutional recognition consisting of laws, standards,
government policies, or plans;
Technical recognition comprising guidelines, scientific or
technical knowledge, or judgment of recognised resource
persons and established experts;
Public recognition representing social or cultural values or
opinion of a segment of the public, especially the stakeholders
directly affected by the proposed project;
IFC performance standards such as the Equator Principles,1 and
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Professional interpretation of the evaluator.

Mitigation: The environmental consultants have used a mix of the abovementioned criteria to carry out the environmental impact assessment of
the proposed project and are thus confident that all possible impacts and
outcomes of the proposed project have been adequately covered.
7.1.2 Prediction of the Magnitude of Potential Impacts
This relates to description, quantitatively (where possible) or

qualitatively, of anticipated impacts of the proposed project. This may be
achieved through use of models or comparison with other similar
activities. The predicted level of impact magnitude may be due to
uncertainties in baseline conditions, proposed activities, external
developments, or the prediction model, or combinations of one or more,
depending on nature of the project and project location, as the case may
be.
Mitigation: Quantum of research involved in the environmental
assessment has assured that the magnitude of potential impacts has been
calculated accurately. Accordingly, the environmental consultants have
been able to predict that potential impact of the proposed project shall
only remain during implementation of the project and that there shall only
be limited impact of the project after completion, which shall be managed
through careful environmental monitoring.
7.1.3 Identification of Mitigation Measures
If it is determined that predicted impact is significant when compared

with established criteria, suitable mitigation measures are identified.
There is a range of mitigation measures that can be applied to reduce
impacts. Broadly, these measures can be classified as under:
Avoiding the possible environmental impact completely by not
launching a certain proposed activity, or any part of such
activity, such as using CFC-free equipment to avoid impact on
the ozone layer;
Reducing impacts by limiting the degree or magnitude of the
activity, for example, minimising dust emission by decreasing
vehicle speed, erecting windshields, sprinkling etc.;
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Rectifying the impact by repairing, rehabilitating, or restoring

the affected environment, and
Compensating for the impact by replacing or providing
substitute resources or environments.
Mitigation: The quality of the environmental impact assessment shall
ensure that all possible mitigation measures shall be identified for
enforcement through institutional arrangements during implementation of
the project.
7.1.4 Evaluation of the Residual Impact
Incorporation of suggested mitigation measures minimises if not

decreases adverse impact of a project and brings it within acceptable
limit. Identification of the remaining impacts after mitigation measures
have been applied is referred to as a residual impact.
Mitigation: The only residual impact shall that be of visual disturbance
by the tall building and disposal of liquid and solid waste. No visual
resources shall be lost after construction of the eight floor structure and
thus there will be negligible visual impact of the project. A wastewater
treatment plant and incinerator are embedded in the project design while
a waste management plan, a mandatory provision under the Hospital
Waste Management Rules, 2005, shall be developed and implemented
through a pre-designated team for appropriate disposal of remaining solid
waste.
7.1.5 Identification of Monitoring Requirements
The last step in the assessment process is identification of minimum

monitoring requirements. The scope and frequency of monitoring
depends on severity, nature and magnitude of residual impacts.
Monitoring assures that residual impacts remain within predicted limits
and provides timely information when an unacceptable impact occurs.
Mitigation: The environmental impact assessment has proposed a
monitoring mechanism that shall be adopted after the project has been
completed to comply with stipulations under the Hospital Waste
Management Rules, 2005. This mechanism shall also serve as a guideline
during implementation of the project.
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ENVIRONMENTAL
SCREENING OF THE PROPOSED PROJECT
An environmental screening matrix has been designed for the proposed

project highlighting obvious, possible and probable environmental
impacts of the project during construction and operation. The matrix
examines interaction of project activities with the environment. Impacts
are broadly classified as physical, biological and social. Each of these
broad categories is thereafter broken up into various scenarios. Potential
impacts could be high negative (adverse) impact, low negative impact,
insignificant impact, high positive (beneficial) impact, low positive
impact, and no impact. The matrix developed for the project under review
is placed overleaf. Negative impacts determined are essentially
unmitigated and appropriate mitigation measures have been suggested
as remedies. Occurrence and severity of potentially adverse impacts
indicated in the Environmental Screening Matrix can be suitably
redressed by adoption of mitigation measures during and after project
implementation. Negative impacts screened through this process are
discussed hereafter.
7.3
ENVIRONMENTAL IMPACT CLASSIFICATION
Potential impacts as brought out in the Environmental Screening Matrix

as a part of the impact assessment analysis are:
Nature (direct or indirect);

Duration of impact (short term, medium term or long term);
Geographical extent (local or regional);
Timing (project phase);
Reversibility of impact (reversible or irreversible);
Likelihood of the impact (certain, likely, unlikely or rare);
Impact consequence severity (severe, moderate or mild), and
Significance of impact (high, medium or low).
Mitigation: Appropriate mitigation measures have been indicated after

the process of classification to reduce if not completely eliminate adverse
impacts associated with project activities. Impact classification is
discussed in the following sections. It is pertinent to point out that
impacts vary according to the nature of a project itself.
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ENVIRONMENTAL
PROBLEMS DUE TO PROJECT LOCATION
An impact resulting from specific location of the project site differs from
those associated with construction and operational phases because
construction and operational impacts are directly linked to activities
ranging from clearing of the land to waste disposal, while specific
location of a project relates to permanence of the project in an alien
environment. In case a site is not sound from an environmental point of
view, alternate site must not only be considered but preferred.
Mitigation: Alternate sites were considered but not found suitable. The
present site is in close proximity to urban areas and is well-connected due
to location on an inter-city route that is free of traffic congestion. The
setting in a rural area on a major road would be convenient for patients
pressed for time.
7.4.1 Siting and Adjacent Land-uses
Use of a site for project implementation can often lead to a less than
optimal use of the site. For example, acquisition of grazing land for a
large factory can lead to less grazing opportunities for livestock.
Secondly, noise, congestion, traffic, arrival of workers and pollution from
such a factory would be a constant source of inconvenience for people
living close by.
Mitigation: The project site is lying vacant. There were reportedly gypsy
families squatting at the site who were removed when the site was set
aside for the tGhulam Muhammad Mahar Medical College. There has not
been any dislocation of legal or illegal occupants from the site on account
of proposed project activities. Moreover, there are no other structures or
activities within or close to the project site that can impinge negatively on
construction or project operation, and vice versa.
7.4.2 Displacement of Other Site Users
Use of a site for project implementation can similarly result in

displacement of previous users. For instance, acquisition of agricultural
land, even in exchange for appropriate compensation, for development of
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a housing scheme would mean that landowners would lose all or a part of
their means of livelihood. Even unauthorised users of the site, such as
squatters, may be displaced, leading to social tensions.
Mitigation: As stated in the previous sub-section, there has not been any
displacement of legal or illegal occupants of the site as a result of the
proposed project.
7.4.3 Local Environment
An assessment must be carried out as to how the proposed project can

impact on the local environment and whether it creates any imbalance in
terms of physical resources or through impacts on the local population.
Mitigation: During the construction and operational phases of the
proposed project, vehicular traffic and operation of construction
machinery etc., could be a source of air pollution. As the construction
contractor would be directed to use good machinery and equipment,
gaseous emissions are expected to be within acceptable levels. Similarly,
various construction activities related to the project will cause a measure
of noise pollution. As per National Environmental Quality Standards, the
maximum permissible noise level for vehicles at a distance of 7.5 meters
from the source is 85dB (A), which shall not be exceeded. During the
operational phase, there shall not be any impact on local environment,
except in the form of visual intrusion, traffic and disposal of liquid and
solid waste. Enforcement of the Environmental Monitoring Programme,
both during construction as well as operation of the project, shall ensure
that there is no discomfort caused to the local inhabitants and that the
environment is not impacted beyond acceptable and tolerable limits.
7.4.4 Availability of Existing Infrastructure
Project implementation can place undue strains on local infrastructure,

particularly when such infrastructure, water supply for example, is barely
sufficient. Similarly, deficient infrastructure or total absence thereof can
cause problems in implementation. In such cases, the proponents must
establish infrastructure, such as roads, to facilitate construction.
Mitigation: The project area has good to excellent coverage of
infrastructure, such as roads, transportation network, electricity, and
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natural gas. Project implementation will thus not be hampered by

inadequate infrastructure. Temporary passages and paths may have to be
constructed to facilitate movement of machinery, equipment and
materials.
7.4.5 Depletion of Resources
Depletion of resources can often take place when there are major projects
under implementation, such as construction of a dam, highways or a new
town development.
Mitigation: Due to the nature of the project, construction shall not result
in depletion of any resources whatsoever and thus the local inhabitants
shall not be inconvenienced over the short or the long term on a
temporary or a permanent basis.
7.5
ENVIRONMENTAL PROBLEMS RELATED TO DESIGN
All issues relating to a site, project area and environment are usually
catered for at the design site of a project. A faulty or sub-standard design
that does not take the local environment and aesthetics into account can
be a source of considerable annoyance for residents and may even lower
property prices.
Mitigation: The hospital has been conceptualised by experienced
consultants and has a state-of-the-art design and shall offer modern
facilities that are deficient in the project area. There shall nonetheless be
limited impacts from the project in the form of shadow, visual intrusion
and earthquake hazard, which are discussed in subsequent sections of this
report along with mitigation measures that shall be adopted for possible
mitigation if necessary.
7.6
ENVIRONMENTAL
PROBLEMS ASSOCIATED WITH CONSTRUCTION
The impact of a project is felt more severely during construction phase,

mainly because the immediate project area can become particularly
vulnerable to environmental disturbance. The main factors that should be
borne in mind in relation to construction activities are:
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Run-off erosion during rains from unprotected excavated areas,

thereby leading to excessive soil erosion;
Danger to workers from accidents, hazardous materials,
quarrying, communicable diseases and emissions;
Local flooding from watering of excavations, flushing of pipes;
Loss or degradation of vegetation from unnecessary removal or
mechanical damage, and
Disruption of local traffic patterns, congestion and blocking of
access to adjoining activities.
Soil characteristics show that the site is suitable for construction.
Construction shall not impact significantly on the immediate
environment.
7.6.1 Acquisition of Land
Land acquisition and payment of compensation is a tedious process

fraught with a horde of issues in a construction project.
Mitigation: No land acquisition proceedings are necessary for the project
since an under-utilised parcel of land shall be used for the project.
7.6.2 Selection of Contractor
Poor selection of a contractor invariably results in delays in project

implementation and can at the same time have a devastating impact on
the environment.
Mitigation: The contractor shall be appointed after due process in line
with standing government procedures and guidelines. Further, the
contractor shall be advised by the proponents to engage casual labour
from amongst local workforce and offer business opportunities to local
businesses, thereby creating a positive socio-economic impact.
7.6.3 Environment Friendly Construction Drills
During the execution of any project, environmental problems mostly arise

within the construction phase.
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Mitigation: The proponents shall take sufficient measures to ensure that

development works do not in any way impinge on the environment on a
temporary or permanent basis. The proponents will hold regular meetings
with the project consultants and the selected contractor to stress
importance of protecting the environment and measures that would be
taken in this behalf. Professionalism of the construction contractor will
reduce the possibility of environmental degradation during project
implementation. The following practices will be adopted by the
contractor under strict supervision of the proponents to protect the
environment:
While all efforts shall be made by the contractor and the
proponents to ensure that negative externalities of the project
during the course of the construction process are minimal, there
will nevertheless be adverse environmental impacts, which will
be addressed appropriately, and without any delay, by the
proponents and the construction contractor;
The proponents shall post signs at the site to inform the general
public about construction activities and duration of works;
A sub-contractor will be engaged for removal of all forms of
waste from the project site and disposal of such waste in such a
manner that it does not impinge on the environment anywhere;
Wherever the excavated earth cannot be disposed locally and
compacted thereafter, it shall be carried away from the site in
closed containers on an emergent and continuous basis through
a sub-contractor;
Construction may take place around the clock on specific days
but will be mainly restricted to daylight hours;
Floodlights could be used whenever construction activities take
place during dark, but the construction contractor will be
advised to control obtrusive light to the maximum extent;
The construction contractor shall use good quality machinery,
equipment and vehicles, which will minimise noise and gaseous
emissions;
Project site will be sprinkled as frequently as possible to
minimise dust pollution;
Construction equipment will be stored within the project site so
that it does not hinder neighbours;
Debris with its main constituents as construction waste,
including clay, sand, crush, stones, paper, plastic, wood pieces,
iron and steel as scrap, wires, rags, ropes etc., shall be disposed
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of expeditiously and appropriately by the contractor through

special arrangement with a sub-contractor;
Building materials will be ordered on need basis only and be
used up quickly so that these do not pile up at the project site;
A materials yards will be set up within the site to store
construction materials strictly on need basis;
Workers employed by the contractor will not be exposed to any
danger and shall wear hard hats throughout the duration of
construction;
Separate garbage drums will be placed for different types of
materials (plastics, paper, cardboard, cloth, metal, glass, wood
and muck);
Inert recyclable waste from the site comprising mainly
cardboard, drums, broken or used parts, etc., will be carried
away by the sub-contractor for sale to licensed recycling
industries;
Hazardous waste, if any, shall be segregated and disposed in
line with rules framed by the government for disposal of
hazardous waste;
Bins will be placed at the site for construction waste, which will
be either reused or disposed through the sub-contractor;
The construction contractor will ensure that first aid equipment
is present at all times and that emergency medical services are
available on an immediate basis in the event of any unfortunate
accident;
Construction site will be off-limits for the public to prevent
damage or accidents by innocent interference;
Noisy works will not be undertaken at night;
The contractor will employ latest construction techniques to
ensure that no harm comes either to workers or people
approaching or entering the project site;
Workers will be insured against accidents as per law of the land
during project activities, and
The contractor shall ensure that the existing infrastructure is not
damaged.
7.6.4 Soil Contamination, Erosion and Degradation
Spills during refuelling, discharges from vehicle and equipment

maintenance, traffic accidents and leakages from equipment and vehicles
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often result in contamination of soil at a construction site. A significant

impact on soil will be interpreted if visible amount of hydrocarbon is
observed in soil. Similarly discharge of effluents to the environment not
meeting the NEQS and other guideline values will also be considered as
an adverse effect. During a typical construction project, spill of fuel,
lubricants, and chemicals takes place during transfer from one container
to another or during refuelling, during maintenance of equipment and
vehicles, due to leakages from equipment and containers, and as a result
of traffic accidents.
Mitigation: Preventive safeguards to be put in place at the construction
site shall be:
Levelling and grading of land will not result in soil erosion of
adjoining areas;
No activity will be undertaken site which can cause leakage and
spillage of oils, chemicals and fuels into adjoining grounds;
Quantities of excavation and fill material will be calculated and
construction shall be planned in such a way that excavated
material is disposed in a manner that it does not adversely affect
environment elsewhere;
Foremen will be nominated to monitor checking of vehicles,
machinery and equipment and make recommendations for
tuning and repairs;
Vehicles, machinery and equipment will not be repaired on
site;
Construction material will be compacted to the extent possible;
In case on-site maintenance of construction vehicles and
equipment is unavoidable, tarpaulin or other impermeable
material will be laid on the ground to eliminate soil
contamination;
The ground will be levelled to the extent possible to avoid
slopes, and
Concrete shall be used wherever it is considered expedient to
prevent soil erosion.
7.6.5 Air Quality Deterioration
Emissions of dust or particulate matter are of serious concern should a

project site be close to a residential area. Particulate matter is generally
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defined as any airborne finely divided solid or liquid material up to the

size of about a hundred microns. PM 10 or particles smaller than ten
microns are considered hazardous for health as they can be inhaled into
the human body. Larger particles also tend to settle rapidly and often do
not reach receptors but in cases where they do so, the dust becomes a
nuisance when it soils property and affects visibility. Since the project
site is urban in nature, preventive steps shall be necessary to maintain
reasonable ambient air standards as dust and emissions from a project site
can travel some distance in the event of strong prevailing winds.
Mitigation: Measures that will be taken to control dust and exhaust
emissions from the project site shall comprise the following:
The primary sources of emissions will be exhausts from dieselengine generators. These shall be properly tuned and maintained
to reduce exhausts
Foremen will be nominated specifically to undertake
inspections of vehicles, machinery and equipment to ensure that
these are not emitting excessive exhaust;
There can be exhausts from construction machinery and
vehicles, which will similarly be kept in good working
condition to reduce possible emission levels to within
acceptable limits;
Dust can add to the pollution of the air. Fugitive dust emissions
will be curtailed by spraying water on soil, where required and
whenever appropriate, particularly when wind is blowing away
from the project site towards settlements, and
Dust emissions from soil piles will be reduced by keeping
materials moist by sprinkling water, erecting windshields
around storage stockpiles and covering stockpiles with tarpaulin
or thick plastic sheets.
7.6.6 Noise Pollution
Depending on construction equipment and distance, receptors may

typically be exposed to intermittent and variable noise levels. During the
day, such noise cause general annoyance and can interfere with sleep at
night. In general, human sound perception is such that a change in sound
level of 3 dB is just noticeable, a change of 5 dB is clearly noticeable, and
a change of 10 dB is perceived as a doubling or halving of sound levels.
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There are various terms used to express noise levels but the main
terminology used is as under:
Sound: A vibratory disturbance created by a vibrating object is
capable of being detected by a receiving mechanism, such as the
human ear or a microphone, when transmitted by pressure
waves;
Noise: Sound that is loud, unpleasant, unexpected, or otherwise
undesirable;
Decibel (dB): A unit-less measure of sound on a logarithmic
scale, which indicates the squared ratio of sound pressure
amplitude to a reference sound pressure amplitude. The
reference pressure is 20 micro-pascals;
A-Weighted Decibel (DBA): An overall frequency weighted
sound level in decibels, which approximates the frequency
response of the human ear. The typical human ear is not equally
sensitive to all frequencies of the audible sound spectrum.
Consequently, when assessing potential noise impacts on
people, an electronic filter is used to deemphasise certain
frequencies in a manner corresponding to the human ears
decreased sensitivity to low and extremely high frequencies. All
noise levels quoted in this report are A-Weighted;
Equivalent Sound Level (L eq ): The equivalent steady state
sound or vibration level in a stated period of time, usually one
hour, which would contain the same acoustical or vibration
energy, and
Maximum Sound Level (L max ): The greatest A-Weighted
sound level with a stated time level. When noise contains a
small number of discrete events, L max is a better indicator of
disturbance to sleep and other activities.
A construction project can create a lot of noise and noise abatement
measures would be necessary for convenience of adjoining areas. Present
levels of noise around the project site show that it is within permissible
limits. Existing sources of noise in the project area include only road
traffic and some commercial activity. Maximum noise level is important
when there are distinct events to the noise. Noise levels at the receptor
due to construction activities will depend on equipment used, period of
exposure and distance from the source. In extreme cases, structures
located within 50 metre of project site may be exposed to noise levels
exceeding 70 dB(A) during the day. Tables 41 and 42 overleaf are an
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indication of typical noise levels generated by the type of machinery and

vehicles that shall be deployed at the project site. The following
illustration provides an idea of sound levels so that noise levels recorded
in the project area and reported at Table 44 can be better understood.
TABLE 43: SOUND LEVELS
Sound Types
Threshold of hearing
Quiet rural night-time
Soft whisper
Quiet urban night-time
Dishwasher in next room
Conversational speech
Vacuum cleaner
Very noisy restaurant
Food blender
Live rock music
Sound Levels
6 dBA
20 dBA
30 dBA
40 dBA
50 dBA
(perceived as acceptable)
60 dBA
(rarely perceived as unacceptable)
70 dBA
(occasionally perceived as unacceptable; telephone
conversation becomes difficult)
80 dBA (generally perceived as unacceptable)
90 dBA
(hearing damage possible, exposed for eight hours)
130 dBA (threshold of pain)
Mitigation: Keeping anticipated impact in view, the proponents shall

adopt following preventive and mitigating measures:
Noise Survey: Noise survey of all construction equipment will
be conducted prior to deployment, and at appropriate intervals
thereafter;
Reduce Noise from Equipment at Source: Based on the
suggested survey, equipment emitting excessive noise in
comparison with other similar equipment will not be employed.
Equipment under use will be regularly maintained, tuned, and
provided with mufflers to minimise noise levels. Equipment in
poor state of maintenance, particularly without effective noise
control, will be checked to determine if it can be improved, and
replaced with less noisy equipment as soon as practicable;
Community Relations: Close interaction and liaison with local
residents and regular monitoring of noise levels in the
community are keys to successful implementation of suggested
mitigation measures. In this regard, nearest residents will be
given sufficient notice about construction activities.
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Consultation shall continue with the local community through

informal and formal meetings. A complaint registering, tracking
and redressal mechanism will be followed. Finally, noise levels
will be monitored regularly in nearby communities to take
timely corrective measures;
Workers will be directed to keep noise levels within acceptable
limits at the construction camp in case any such camp is set up;
Workers will be under strict instructions to refrain from using
radios etc., at loud volume during off-work hours;
Workers shall keep noise levels low;
Construction equipment and vehicles will be equipped with
mufflers to effectively curtail generation of noise, and
Drivers of construction vehicles shall be under strict
instructions to desist from blowing horn at the project site and
on the roads.
Noise tests carried out on August 23, 2011 indicate that noise levels at the
project site are well within the normal levels despite location of the
project on an inter-city road.
7.6.7 Surface Water and Groundwater Contamination
Construction projects can lead to contamination of surface and

groundwater resources if precautions are not taken.
Mitigation: Corrective measures recommended earlier to forestall soil
contamination will also prevent contamination of groundwater. There is
no surface water close to the project site that can come under threat due to
project implementation.
7.6.8 Construction Labour
Construction shall create employment for a total of two hundred workers.

Arrival of a workforce can lead to inconvenience and result in friction
with local residents in case suitable protocols are not devised.
Mitigation: A construction camp shall be established only on need basis.
Such camps are usually not necessary in urban areas where workers can
easily travel to work site from their places of ordinary residence and there
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shall thus in all probability not be any construction camp at the project
site. Workers shall be under strict instructions to avoid intrusion into
privacy of local neighbourhoods and shall not wander into residential
areas without sufficient cause or loiter unnecessarily.
7.6.9 Safety Hazards, Public Health and Nuisances
A construction project can lead to situations where there are hazards to

safety, public health is threatened and nuisances are created.
Mitigation: Following measures will be adopted to reduce if not
eliminate possible threats from project implementation to local
community:
Drivers using construction-related vehicles will be instructed to
drive vehicles safely;
Noise reduction protocols in the preceding section will prevent
public nuisances resulting from noise pollution;
The speed of project vehicles close to built-up areas will be kept
low to avoid accidents and dust emissions;
No activity will be undertaken at the site which can pose threat
to public health, and
Mitigation measures discussed earlier for air quality impairment
and soil and water contamination shall also address concerns
about public health.
7.6.10 Damage to Infrastructure
Construction projects often cause damage to infrastructure if appropriate

precautions are not adopted.
Mitigation: The construction contractor shall adopt the following steps to
prevent any possible damage to local infrastructure:
Vehicles carrying construction materials will not be overloaded
and cargo shall correspond to maximum load allowable under
the law so that undue stress is not placed on roads;
The foremen on duty at the construction site will have complete
access to layout of public infrastructure, if any, both on surface
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and subterranean, and will thus be fully aware how to conduct

construction works and avoid unwitting interference;
Utmost care will be taken to ensure that existing infrastructure
is not damaged;
Prior permission shall be sought from public sector agencies
and municipal authorities for unavoidable works that involve
excavations into or around or above public infrastructure at the
construction site, if any, and
The proponents shall take immediate measures to restore if not
improve infrastructure damaged unintentionally, or through
negligence or by design or on account of inevitable or
unavoidable circumstances.
7.6.11 Increase in Vehicular Traffic
There shall be a marginal increase in traffic during project

implementation and when the project is in operation. Impact of the
project on local traffic is discussed in Chapter 10.
7.6.12 Dewatering and Drainage
Absence of dewatering and drainage can have the same effects as

explained in the previous section. The amount of water to be removed
from a site could be nominal to a large volume, depending on the height
of the water head, permeability of soil below the water level and the size
of the area to be dewatered.
Mitigation: Water table at the site exists below a depth of six feet where
tower footing will be seated for construction of basement and efficient
dewatering will be required during deep excavation, especially below the
water table. Accordingly, the site will be dewatered for the following
reasons:
To stabilise the banks of excavation and avoid hazards posed by
slopes and sloughing;
To prevent disturbance of soil at the bottom of excavation
caused by boils or piping and such disturbances reduce soil
bearing capacity of soil, and
To provide suitable working surface at the foot of excavation.
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Proper dewatering prior to construction shall ensure that the structure

remains stable during the operational phase.
7.8.13 Erosion Control
Erosion of soil even after a structure has been completed can have
devastating effects, considering especially that site soil is susceptible to
erosion.
Mitigation: Erosion may be possible due to ground undulation. Specific
recommendations to mitigate the potential for erosion can be provided
during grading. These issues can be addressed through protection of
critical areas with erosion control materials such as lined interceptor
ditches or diversion dikes above fill and cut slopes, and construction of
slope drains to safely direct concentrations of surface water runoff to a
more suitable location down-slope. It should, however, be expected that
even with carefully planned construction and designed erosion control
measures, some erosion will occur during the first few wet seasons after
the project is completed. Accordingly, site grading will be inspected,
particularly after heavy, prolonged rainfall, to identify erosion areas at an
early stage. Maintenance works shall be carried out if necessary and as
soon as practical so as to repair such areas and prevent their enlargement.
7.8.14 Temporary Excavations
Temporary excavations, if carried out without thoughtful planning for

possible consequences, can endanger a project during or after completion.
Mitigation: Conventional earth-moving equipment shall be adequate to
excavate the soil at the site. Temporary excavations in the site of silty or
sandy clayey soils to a depth of six feet shall be sloped at an incline of
1.5:1 (horizontal:vertical). However, depending on moisture and density
conditions during grading, slopes of 2:1(horizontal:vertical) could be
necessary. Below six feet depth, slopes of 1:1 and steeper may be
possible. The site engineer shall maintain safe cut slopes based on actual
field conditions and safety requirements. Where the excavation bottom is
locally wet, soft and yielding, the bottom shall be stabilised prior to
placing fill. Methods such as the use of pit-run gravels and cobbles on the
excavated bottom covered with a geo-textile fabric or membrane such as
Mirafi 600X or placement of a Class-II base material over a similar fabric
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shall be employed on need basis. Where temporary trench slopes are

inclined as described in the preceding lines, shoring might not be
required. However, where adjacent features may influence establishment
of appropriate slopes, the site engineer shall select shoring. Personnel
shall not under any circumstances enter trenches with vertical sidewalls
greater than five feet depth without proper shoring.
7.6.15 Rollers
The choice of rollers to be deployed for compaction must be based on soil

characteristics.
Mitigation: A sheep foot roller without vibrations shall be used for
clayey ground while vibratory smooth drum roller will be employed on
sandy soil ground.
7.6.16 Blocked Access
Development activities can block existing routes or disturb the right of

way, thereby causing disturbance and inconvenience for local residents,
especially when site development or construction forces local residents to
adopt longer routes or when short cuts are no longer available.
Mitigation: Construction at the project site shall not impede any existing
routes or violate the right of way. Construction vehicles shall enter or
leave the site in an orderly manner without obstructing local traffic.
7.6.17 Gender Issues
Presence of a sizable workforce at the project site can result in gender

issues, and be a source of discomfort especially for female pedestrians.
Mitigation: The following practices will be observed to eliminate
possibility of gender-related incident and to protect privacy of residents:
Local workers will be employed who would be fully aware of
local customs, traditions and values and will accordingly be
expected to abide by highest moral and ethical standards;
Workers will be discouraged from entering built-up areas, and
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Under strict supervision of foremen, the construction crew shall

be bound to a strict code of moral conduct.
7.6.18 Site of Archaeological or Historical Significance
The project area is rich in terms of monuments of archaeological,

historical and religious significance. No such monument shall be under
direct threat from project implementation. Since the project area is urban
and there have been continuous development works over the years,
archaeological or historical findings during excavation works are
unlikely. However, an artefact of significance discovered during the
phase of construction would be delivered to the Archaeology Department,
Government of Pakistan, in compliance of the Antiquities Act, 1975.
7.7
HEALTH AND OCCUPATIONAL SAFETY
Inconvenience and discomfort for workers and accidents resulting from

careless construction practices can result in disruption of project
implementation, as also socio-economic issues. Although it shall be the
responsibility of the construction contractor to ensure occupational safety
for workers at project site, the proponents will issue explicit instructions
for observance of occupational safety and to abide by labour and safety
standards.
Mitigation: Following measures shall be taken by the contractor under
supervision and inspection of the proponents:
All labour and occupational safety laws and regulations will be
fully observed;
Wages shall not be below minimum wage fixed by the
government;
No deductions will be made from wages unless prior
arrangement in writing has been made with workers regarding
provision of services and benefits;
Women workers, if any, shall be paid standard market wages, at
least equal to minimum wage;
In case there are women workers, the contractor shall make
suitable arrangements for their camp, if required, and shall also
issue a strict code of conduct regarding interaction;
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There shall not be any bonded or child labour;

Working hours shall be according to the law of the land;
Wages will be disbursed on time;
The contractor will maintain a register of wages, which shall be
open for inspection by the proponents;
In case labourers, masons and other employees are made to
work beyond normal hours, they will be paid overtime
according to the law of the land;
Workers shall be insured against accidents;
No worker will be exposed to dangerous work;
Hard hats will be worn by all workers and foremen;
Masks will be available for workers to avoid dust inhalation;
Workers shall be briefed about health hazards and all
precautions that must be taken during construction;
Maximum number of employment opportunities will be
provided to local workers so as to impart training and skills to
local workforce;
A medical team will be engaged by the contractor to attend to
health needs of workers and shall be available at short notice in
case of an accident;
Adequate first-aid arrangements will be made at project site as
immediate relief in case of an accident;
The contractor will prepare an emergency plan so as to be fully
prepared for an emergency situation, and
Fire extinguishers and other emergency equipment shall be
available at the construction site.
ENVIRONMENTAL
PROBLEMS FROM PROJECT OPERATIONS
There will not be any environmental problems relating to gaseous

emissions, particulate matter or noise during operation of the project.
Environmental issues associated with operation of the proposed project
are discussed in the following sub-sections.
7.8.1 Earthquake Hazard
While an earthquake can cause damage to a particular structure, it

becomes an environmental hazard should there be possibility of such
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damage from seismic activity directly impacting on the local

environment. This could, for example, include debris falling on adjoining
properties. Accordingly, a property owner would be wary of a high-rise
being constructed close by. The region is placed in Seismic Zone 2A and
is thus susceptible to seismic activity. Construction of the building can
thus pose hazards if there are nearby properties.
Mitigation: Foundations of the building have been designed and shall be
constructed to respond to seismic activity typical of the region and there
shall thus be no threat to the safety of any people immediately close to it.
In any case, there is no structure close to the project site that shall be
exposed to any such danger.
7.8.2 Visual Impact
There can be visual impact of any type of project and it can ordinarily
take three forms: firstly, it relates to the visual impact that a structure
creates when it is completed; secondly, to what extent it affects visual
impact of surrounding areas, and thirdly, how a proposed structure affects
the view of neighbours.
Mitigation: As explained in the preceding sub-section, the building is to
be constructed in a rural area and thus the visual impact shall be of
limited consequence as there are usually very few visual resources in
such locales. The building shall nevertheless interfere with the skyline but
not be an eyesore.
7.8.3 Noise
Noise is a serious environmental concern and results mainly from

vehicles, industry and commercial units. It assumes even more serious
proportions when accompanied by vibrations. Control over environmental
pollution from noise is hindered by insufficient knowledge of its effects
on humans and lack of defined criteria. Noise pollution is aggravated
progressively due to poor planning in urban centres, road construction,
increase in number of vehicles and development of utilities infrastructure.
A Pakistan Environmental Protection Agency study has observed that
urban centres are becoming noisier due to high traffic intensity and acute
deficiencies in traffic management.1 The immediate project area is
commercial-cum-administrative in nature and as stated earlier, there will
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not be any significant increase in volume of traffic when the hospital is

operational. Traffic on the road facing the project site is currently low to
medium, and it has the capacity to bear additional traffic load. Samples of
noise levels taken at the project site are shown in Table 44 overleaf,
which indicate that noise levels presently are within acceptable limits.
Mitigation: Noise levels are not expected to increase as a result of
operation of the project but there might be a slight rise from additional
traffic generated by the project. Much of the noise, if any, within the
hospital shall not be audible in areas close by. The proponents shall
however ensure that all vehicles with origins in the hospital abide by
minimum noise protocols when in operation and that machinery and
equipment that can add to noise levels, such as elevators, air-conditioning
plant, motor pumps, tube-well and generators, are kept under due
maintenance so that noise levels do not exceed upper noise limits set
down by the National Environmental Quality Standards. There shall not
be generation of excessive noise beyond the maximum noise standard of
85 dBA.
7.8.4 Shadow
Effects of the shadow of a high-rise can cause an environmental impact in

terms of slight loss of light and energy for properties upon which the
shadow falls.
Mitigation: The building shall cast only nominal shadows that shall be
within the compound and thus not impact on any adjoining properties.
7.8.5 Increase in Vehicular Traffic
Operation of a hospital can increase traffic levels in the project area and
special measures, such as construction of on-ramp and exit-ramp, may be
necessary to ensure that the flow of local traffic is not altered beyond
reasonable limits or disturbed and that sufficient parking spaces are
provided within the compound.
Mitigation: There shall be marginal increase in vehicular activity on
completion of the proposed project. Eighty parking spaces for cars and
four hundred and three hundred and twenty for motor-cycles have been
provided in the project design through dedicated basement parking.
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Details of traffic impact are covered in Chapter 10 covering the Traffic

Impact Analysis. Operation of the project will at the same time result in
reduction of as much traffic from other hospitals.
7.8.6 Water Consumption
The hospital shall draw water for its needs from tube-wells. Daily
requirement shall be an absolute maximum of 44,138 gallons. A detailed
write-up on water usage is available in a previous section of this report,
followed by details of wastewater generation when the project comes into
operation, which indicates that there shall not be any adverse impact due
to water usage or excessive wastewater.
Mitigation: Despite having independent source of water through tubewells, the proponents shall endeavour to avoid wastage of water. Water
conservation measures are given in the following section.
7.8.7 Water Conservation
A large hospital uses up large volumes of water and measures must be

taken to conserve water resources.
Mitigation: The proponents shall take the following measures for
conservation of water:
The proponents shall install low-flush water closed toilets (1.6
US gallons per flush) instead of traditional four gallons;
Systems could be put in place to design the drainage system so
that wash-basin and shower grey water can be recycled to use
for irrigation of green areas and plantations;
Patients and visitors shall be given politely-worded memos to
conserve water in bathrooms, for example by shutting off water
while brushing teeth and shaving;
Proponents shall procure water-saving equipment;
Treated water from the wastewater treatment plant shall be used
to irrigate green areas and plantations;
An effective employee training programme shall be instituted to
create awareness about water conservation;
Regular checking of taps to ensure that these do not drip;
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Use of sensor-fitted taps that turn off automatically;

Use of sensor-fitted urinals taps that cut water supply when not
in use;
Messages shall be placed in bathrooms to conserve water and to
minimise use of hospital towels and linen, and
Due maintenance of water pipes to prevent leakages.
Janitorial and cleaning staff shall be trained and instructed to follow the
following protocols:
Taps shall not be kept running while cleaning the bathrooms
and maximum use shall be made of buckets;
Minimum amount of detergent shall be used in the laundry to
reduce suds that need to be washed off with large volumes of
water;
All faucets, water pipes, circulating pumps shall be regularly
inspected for faults and leakages to avoid drips, and
Any leaking faucet or pipe shall be reported immediately.
The following mitigation measures shall be adopted in the kitchen and
while serving food to patients:
Food products shall be washed in buckets, bowls or containers;
Dishwashers with sufficient loads shall be installed, and
Infrared activated faucets shall be fitted wherever practicable.
7.8.8 Wastewater and Sewerage
About 32,842 gallons of wastewater shall be generated when the project

comes into operation.
Mitigation: As wastewater will not be industrial or commercial in nature
but may have contaminants due to use of medicines and chemicals in
laboratories, prior treatment of the wastewater will be necessary before it
is discharged into the sewerage network. The project design includes
installation of a wastewater treatment plant. A write-up on the proposed
wastewater treatment plant is given in Chapter Five. Most of the treated
water shall be reused at the premises to irrigate plantations and green
areas. Sufficient capacity is available with the municipality to receive and
dispose of remaining treated wastewater.
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7.8.9 Surface Drainage
Concentrated surface water runoff within or immediately adjacent to

structures can have destabilising impact thereon.
Mitigation: Runoff shall be conveyed in pipes or in lined channels for
discharge through municipal drains and shall not be released into any
area, whether level or not, where it can cause erosion. Water from roof
downspouts will similarly be conveyed in pipes that shall discharge
rainwater safely away from the structure. Surface gradients shall be
planned to prevent ponding and ensure drainage of away from building
foundations, treatment plant components, pavement edges and sidewalks,
maintaining a minimum of two percent gradient.
7.8.10 Contamination of Soil, Surface and Groundwater
Project operations can cause contamination of soil and groundwater as

well as surface water, depending on the nature of a project.
Mitigation: Solid waste generated at the building will be disposed of in
accordance with the law by incineration or through a waste management
contractor. As there is no surface water close to the project site, there can
be no threat to surface water from project activities. These aspects are
dealt with in detail in the next chapter covering the Environmental
Management Plan.
7.8.11 Obtrusive Light
Light pollution is as much a nuisance as dust, noise, vehicle emissions

and industrial fumes. Accordingly, obtrusive light can cause serious
physiological and ecological problems. Obtrusive light, whether it keeps
a person awake through an open window or impedes view of the night
sky, is a form of pollution and must be substantially reduced without
detriment to the need for lighting. Obtrusive light causes nuisance to
others, wastes money and electricity and results in unnecessary emissions
of greenhouse gasses. Obtrusive light can be classified as follows:
Glare: Uncomfortable brightness of a light source when viewed
against a dark background;
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Sky Glow: Brightening of the night sky above built-up areas,

and
Light Trespass: Spilling of light beyond boundaries of the
property or area being lit.
Mitigation: Necessary measures to be taken for elimination of obtrusive
light are covered in detail in the Environmental Management Plan in the
next chapter.
7.8.12 Safety Hazards, Public Health and Nuisances
Operation of the hospital may cause some concerns for safety, public
health and nuisances within the project area.
Mitigation: Measures discussed earlier for air quality impairment and
soil and water contamination will also address concerns about public
health. The proponents shall undertake pest extermination exercises on a
regular basis in order to maintain appropriate health and sanitation levels
within the hospital and its compound.
7.8.13 Vibrations
Equipment can cause vibrations that can be source of constant discomfort

for neighbouring properties.
Mitigation: The premises shall be employed strictly for medical purposes
and thus there shall be no vibrations originating from the hospital when it
comes into operation. Equipment installed at the project that can cause a
measure of vibration shall include elevators, air-conditioning plant, water
pumps, tube-wells and generators. The proponents shall ensure that no
activity takes place at the premises that can create vibrations.
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ENVIRONMENTAL MANAGEMENT
This part of the study discusses the Environmental Management Plan and
describes institutional arrangements required for its effective
implementation and follows from possible environmental impacts
identified in the previous chapter. While mitigation measures have been
given in respect of all such environmental impacts, a comprehensive
environmental plan is nonetheless necessary, as it renders a delivery
mechanism to reduce adverse environmental impacts of a project during
execution, enhance project benefits, and introduce standards of good
practices to be adopted for all project works. An elaborate environmental
management plan and monitoring surveillance programme, including
periodic progress reports, has to be devised to guarantee that the project
does not create any adverse environmental impact during the construction
phase as also upon operation. The basic aims of the Environmental
Management Plan in Table 45 placed at the start of this chapter are to
facilitate implementation of mitigation measures indicated in various
sections of this study, and delineate responsibilities of the project
proponents, consultants and contractor to counteract nominal
environmental impacts. During the construction phase of the proposed
project, sole responsibility for compliance with the Environmental
Management Plan shall be with the proponents of the project through the
project designers and the contractor.
Mitigation: The construction contractor shall carry out field activities as
part of project execution and will be responsible to implement various
mitigation actions prescribed in the Environmental Management Plan
relevant to the contract. The contractor shall also be subject to certain
liabilities under the environmental laws of the country, and under contract
with the project proponents. The consultants will monitor the contractor
and ensure implementation of the Environmental Management Plan.
Environmental management shall assume a different facet during
operation. Measures to be adopted by the proponents are described in the
following paragraphs.
8.1
SECURITY
Security of the hospital will not be a major issue but must be borne in
mind nonetheless.
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Mitigation: Security guards shall be posted at the main gates to maintain

safety at the premises and also to ensure that unauthorised people do not
enter the compound.
8.2
VEHICLE PARKING
Traffic from a relatively large building such as the proposed project adds
to local traffic and appropriate measures must be taken to alleviate traffic
issue.
Mitigation: The proponents shall ensure through security guards that no
vehicles are parked on the road in front of the hospital for a protracted
time period. All such vehicles shall be parked within the large compound
where they do not impede normal traffic. Space reserved for vehicles in
the basement will not be put to any other use. Parking on the immediate
front of the hospital shall not be permitted except for ambulances and
patients alighting from vehicles.
8.3
ENVIRONMENTAL ENHANCEMENT MEASURES
Possible environmental impacts resulting from operation of a large

hospital requires certain measures for environmental protection and
enhancement.
Mitigation: The following steps shall be taken by the proponents to
enhance the local environment:
Adequate drains will be fixed at all levels of the building for
disposal of rainwater;
Treated sewage will be discharged into the sewer system;
The visual impact of the building on its surroundings has also
been taken into consideration. Accordingly, the hospital has
been designed keeping in mind aesthetic values and its faade
will be most presentable;
Attempts would be made to use as much frosted or patterned
glass as possible, without compromising aesthetic value of plain
glass;
Use of glass for windows will be kept to reasonable limits to
reduce solar reflections that may inconvenience neighbours;
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Space for electric sub-station and/or transformer installation

will be provided at the premises, subject to need;
As far as land use of the immediate environment is concerned, it
is generally administrative and there will, therefore, not be any
threat to privacy of adjoining properties;
All windows facing neighbours will be strictly of the specified
size and placed at a height prescribed under building
regulations;
Sufficient open space has been provided around the hospital for
plantation, green area and passages;
In order to keep the environment neat and clean, the space
between the road and the proposed hospital will be paved with
tiles or developed as a green belt, with prior permission from
the relevant government authority, and
No vendors will be allowed to carry out business in front or
inside the hospital.
8.3.1 Energy Conservation
Commercial buildings such as offices, institutional facilities, retail

facilities, hotels or hospitals similar to the project under review etc.,
consume about five 5 percent of electricity generated in Pakistan, which
is about 650 megawatts of energy per year. It is estimated that within
commercial buildings, lighting constitutes 30 percent of electricity
consumption. Consequently, commercial lighting accounts for about 1.5
percent or so of the nations electricity consumption. Improving lighting
system efficiencies by up to 50 percent, which is quite plausible, can
result in saving up to 0.75 percent of electricity use. Lighting in
commercial buildings is typically used during daytime peak demand
periods. Accordingly, commercial lighting loads contribute to significant
energy shortfalls during such times, usually around midday. Additionally,
electric lighting, by its very nature, contributes to cooling load of
commercial buildings, thereby placing increased burden on heating/
ventilating/air-conditioning (HVAC) system and resulting in yet more
power consumption. Lighting probably adds to at least 20 percent of
cooling load. Improving lighting system efficiencies by up to 50 percent
can thus significantly improve peak demand conditions while reducing
HVAC requirements by 10 percent in commercial buildings. Finally,
economic productivity is directly related to the workers abilities to
effectively and efficiently perform their work in commercial buildings.
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Improved lighting quality can contribute to productivity gains. Even if

these gains are relatively small, for instance only 0.25 to 0.5 percent, it
would still be significant in the larger context of commercial-sector
contribution to overall economic growth. Pakistans commercial building
owners are paying the going market rates for electricity, while using
outdated inefficient electric lighting equipment. Lighting quantity and
quality can be dramatically improved and more can be achieved with less
electricity. A comprehensive review of the State Life Insurance Company
Building No. 9 in Karachi, for example, indicated that lighting energy
consumption can be reduced by 69 percent while increasing lighting
quantity at the same time by 53 percent and quality (e.g. hardcopy task
contrast improvements, colour rendering improvement and significant
reduction in noise and flicker effects).1 Electric lighting efficiency
improvements are so dramatic that even when considering more costly
tariff-burdened state-of-the-art lamps/ballasts/ luminaires, cost recovery
is just over five years, which does not include the important factor of
improvements in worker productivity. Lighting efficiency is not only
dependent on quality of design and products, but is also quite dependent
on quality of installation. Additionally, new techniques such as tandem
wiring ballasts in order to reduce quantity of ballasts as well as increase
operating efficiency by as much 10 percent to 20 percent, need to be
adopted. Further, the significance of new energy-efficient lamps, ballasts,
luminaires and wiring methods, needs to be understood. Providing an
efficient lighting infrastructure in a built environment does not assure
continued efficiency over the life of the infrastructure. Lighting efficiency
over time is influenced by a host of issues, not the least of which are
proper lamp replacement, proper ballast replacement, proper luminaire
cleaning programme and proper room surface finish maintenance (e .g.
repainting with light finishes rather than dark finishes).
Mitigation: In conjunction with measures described in the preceding
paragraphs, the proponents and users of the hospital could consider the
following steps for conservation of energy when the project enters the
operational stage:
Lights shall be switched off when not required;
Protocols can be devised so that users are encouraged to switch
off access to air-conditioning beyond a certain temperature
threshold;
Thermostats in private rooms in any case shall enable
adjustment of temperature to avoid over-cooling and
overheating, thereby lessening the load on energy consumption;
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The air-conditioning plant shall be operated to maintain

desirable temperatures within the building and both overcooling and overheating shall be avoided;
The air-conditioning system shall be designed and installed in
such a way that portions of the hospital not requiring airconditioning can be disconnected from the main supply so that
the air-conditioning plant can operate at lower capacity;
Maximum use of natural light and fresh air shall reduce energy
costs in terms of lighting and cooling;
Lighting-efficiency measures in the preceding paragraphs shall
be adopted to the extent possible and feasible;
Hospital administration would be encouraged to purchase
energy-efficient lights and appliances;
Energy-efficient lights and appliances as suggested in the
preceding paragraphs would be installed in an energy-efficient
manner adopting latest techniques recommended by
professional organisations;
The proponents shall use heat-absorbent colours within the
building and on the exterior of the building so as to reduce
cooling load;
The proponents shall also consider using Green Roof and Cool
Roof criteria to reduce cooling costs;
The proponents shall carry out lighting audits at regular
intervals to work out lighting and cooling costs through use of
energy-conservation regimes and replacement of lamps and
appliances with lower energy consumption;
Dimmers shall be used for lighting and fans;
All equipment shall be under due maintenance, and
Electricity mains and wiring shall be inspected at suitable
intervals to prevent risks to life, reduce electricity losses and
eliminate short-circuiting.
8.3.2 Environment-friendly Equipment
Equipment using obsolete technology can create pollution and even

health hazards.
Mitigation: The proponents shall ensure that the air-conditioning plant to
be installed at the hospital and all refrigerators for storage of medicine
and other purposes are CFC-free.
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8.3.3 Solar or Wind Energy
Use of solar panels or harnessing wind energy for power generation has
not been considered by the proponents as the technology is too expensive
and not feasible considering the size of the proposed project. Moreover,
there is no wind corridor within the project area that can be availed for
the purpose of power generation even to meet requirements partially.
8.3.4 Quality Control
Establishments providing public service must ensure that best

international practices are adopted so as to ensure quality control and
complete safety at the premises.
Mitigation: The proponents shall apply for ISO-certification as soon as
the hospital comes into operation so that t can offer the best possible
services to the public.
8.3.5 Minimisation of Liquid and Solid Waste
Minimisation of liquid and solid waste during the operation of the

hospital is as important from the environmental point of view as is
ultimate disposal.
Mitigation: Liquid and solid waste shall be minimised using the
following methods:
Taps and urinals in the washrooms shall be fitted with sensors
to conserve water;
The management shall test sensors and all taps and water outlets
periodically for leakage;
All dripping taps shall be fixed immediately to reduce wastage;
Rubbish bins and baskets shall be placed in all corridors and
work areas and shall carry a message to reduce solid waste;
All hydrants and taps in the compound shall be similarly tested
frequently to ensure that there is no leakage;
Hospital administration shall also install, to the maximum
extent possible, taps that turn off automatically, and
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Separate bins and baskets will be earmarked for solid waste that
can be recycled, so as to facilitate ultimate disposal.
8.3.6 Inflow of Natural Light
Natural light is a precious resource often ignored or under-estimated by

public. Maximum use of natural light can lead not only to conservation of
energy but it also acts as an antiseptic.
Mitigation: Natural light shall be captured through windows and will be
circulated within the building through wide corridors and there shall be
sufficient windows in the rooms to capture natural light.
8.3.7 Circulation of Fresh Air
Fresh air is essential for sound health since closed spaces can lead to
staleness and also claustrophobia.
Mitigation: Even though the building shall be air-conditioned,
employees and patients shall be encouraged to open windows frequently
to ensure inflow of fresh air.
8.3.8 Reduction of Obtrusive Light
An important environmental enhancement measure is reduction of

obtrusive light from the proposed project that can cause inconvenience to
neighbours.
Mitigation: Although it is quite unlikely that the hospital shall be highly
lit up, following measures could be taken by the proponents when the
project comes into operation in order to reduce obtrusive light, if any:
Only those lights shall be switched on at night, and those too at
dimmed levels, as are absolutely necessary for the sake of safety
and security;
Proponents shall use specifically designed lighting equipment
that minimises upward spread of light near to and above the
horizontal;
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Proponents shall take care to select luminaires to ensure that

appropriate units are chosen and that their location will reduce
spill light and glare to the minimum;
Proponents would take care not to over light, which is a major
cause of obtrusive light and is a waste of money and energy;
Employees would be instructed to dim or switch lights off when
tasks are finished;
Proponents shall keep glare low by ensuring that the main beam
angle of all lights directed towards any potential observer is not
more then 70;
The proponents shall use light dimmers instead of switches;
Appropriate measures will minimise upward reflected light, and
Higher mounting heights shall be employed as these allow
lower main beam angles, which assist in lowering glare.
8.3.9 Plantations and Landscaping
Land development often results in alterations in the local environment,

which must be compensated through restoration of green areas or through
fresh plantation.
Mitigation: Proper landscaping shall be carried out through a qualified
consultant to be selected as the construction phase nears completion.
Large size of the plot does shall facilitate a sizable plantation campaign
within the premises. However, dense tree plantation shall be duly
considered after the project has been completed, in consultation with a
horticultural specialist. There is no municipal stipulation requiring the
proponents to pre-define exact area to be brought under plantation.
Some of the open area shall be available for greening and exact area can
be calculated only when the hospital has been completed and landscaping
is undertaken. An amount of Rs. 2.632 million have been set aside in the
project cost estimates for horticulture at the project site, which shall
provide for planting of two hundred and ten trees and shrubs and at least
five hundred floral plants, aromatic flowers etc., and a few more in the
space between the building line and the road, after prior permission is
obtained from government authorities. It shall however be ensured that
selected varieties are environment-friendly and indigenous and that the
chosen varieties have less demand for water. The proponents shall
consider indoor plantations after the hospital is in operation.
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8.4
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GREEN BUILDING
Green building is the practice of increasing efficiency of buildings and

their use of energy, water, and materials, and reducing impacts on human
health and the environment, through better siting, design, construction,
operation, maintenance, and removal, or the complete building life cycle.
A similar concept is natural building, which is usually on a smaller scale
and tends to focus on the use of natural materials that are available
locally. Other commonly used terms include sustainable design and green
architecture. However, while good design is essential to green building,
actual operation, maintenance, and ultimate disposal or deconstruction of
the building also have very significant effects on buildings overall
environmental impact. Effective green building can lead to:
Reduced operating costs by increasing productivity and using
less energy and water;
Improved public and occupant health due to improved indoor
air quality, and
Reduced environmental impacts by, for example, lessening
storm water runoff and the heat island effect.
Mitigation: There is no compulsion, however, under the building
regulations or byelaws to adhere to features of Green Building. Although
a number of features of the Green Building Programme have been built
into the design of the project under review, the project designers and
project consultants shall endeavour to incorporate other features too as
the phase of construction progresses. These shall include measures
relating to cool roofs and green roofs. The following measures have
however so far been taken by the proponents and project designers to
abide by the Green Building concept:
The project site has been chosen with the express intention of
locating it an area that is not congested;
The building design is environmentally sound particularly to the
extent that it is not wasteful;
The architectural plans cater for maximum use of natural light;
All construction materials are to be procured through nearest
sources, which shall reduce not only transportations costs but
also cut down on resultant emissions from vehicles carrying
such materials;
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Shrubs within the plot that will be removed only if necessary

shall be reused for construction of the project office;
Trees within the plot are to be preserved and integrated into the
project design;
Removal of shrubs and other minor vegetation cover that may
be removed during land clearing shall be suitably compensated
for through a plantation plan and developing grassy plots and
green belts to create a green effect;
Well-insulated windows, doors, and walls shall help reduce
energy loss, thereby reducing energy usage;
The outer walls shall have cavities, which will be filled with
thermopore to provide insulation against summer heat;
Boulders and stones recovered from excavation during site
development, if any, shall be reused in construction;
The roof shall have a number of features relating to cool roof
concept, including mud layers and polythene sheets, which shall
absorb heat;
Hollow bricks will be used wherever advised by the project
designers;
The proponents shall advise employees and patients about
measures that can be adopted for conservation of energy and
water;
The architectural design caters for maximum inflow of fresh air
and circulation;
Colour schemes both at the exterior of the building and inside
shall be used that absorb heat and give a cooling effect so that
energy consumption is lowered correspondingly, and
The best technical expertise shall be deployed to select and
install electrical wiring and equipment that is not only safe but
also consumes less energy.
8.4.1 Cool Roofs
Over 90 percent of roofs in the United States are dark-coloured so as to

absorb heat due to climatic conditions. Rooftops and walls in Pakistan are
often tarred to provide insulation against rain and damp. Low-reflectance
surfaces from dark rooftops reach temperatures of 66C to 88C and
contribute to:
Increased cooling energy use and higher utility bills;
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Higher peak electricity demand, raised electricity production

costs, and a potentially overburdened power grid;
Reduced indoor comfort;
Increased air pollution due to the intensification of the heat
island effect, and
Accelerated deterioration of roofing materials, increased roof
maintenance costs, and high levels of roofing waste sent to
landfills.
In contrast, cool roof systems with high reflectance and emittance stay
up to 39C cooler than traditional materials during peak summer weather.
Benefits of cool roofs include reduced building heat-gain and saving on
summertime air conditioning expenditures.1 By minimising energy use,
cool roofs do more than save money and reduce demand for electric
power and resulting air pollution and greenhouse gas emissions. An
estimate of cool roof energy savings can be determined by considering
the following main characteristics:
Air-conditioning: Cool roofs can reduce summertime energy
use in air conditioned buildings. In buildings without air
conditioning, cool roofs can improve comfort by reducing topfloor temperatures;
Roof Insulation: Cool roofs save more energy when installed
on buildings with low roof insulation;
Attic Radiant Barrier: These structures reduce energy saving
potential of cool roofs;
Attic Ventilation: Buildings with low attic ventilation see
greater benefit from a reflective roof, and
Local Climate: Cooling energy savings are typically greatest in
areas with long, sunny, hot summers.
Mitigation: The project design incorporates various features of cool roof
as discussed above, and shall also include adoption of Heat Island
reduction measures such as, among others, planting trees and vegetation,
and using cool paving, which can all save energy by lowering
temperatures and decreasing air conditioning demand.
8.4.2 Green Roofs
Another alternative to traditional roofing materials is a rooftop garden, or

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green roof. On hot summer days, the surface temperature of a vegetated

rooftop can be cooler than air temperature, whereas surface of a
traditional rooftop can be up to 50C warmer. A green roof consists of
vegetation and soil, or a growing medium, planted over a waterproofing
membrane. Additional layers, such as a root barrier and drainage and
irrigation systems may also be included. Green roofs can be used in many
applications, including industrial facilities, residences, offices, and other
commercial property. Green roofs are an attractive roofing option that can
reduce urban heat islands by providing shade and through
evapotranspiration, the release of water from plants to the surrounding
air. They also:
Reduce sewage system loads by assimilating large amounts of
rainwater;
Absorb air pollution, collect airborne particulates, and store
carbon;
Protect underlying roof material by eliminating exposure to
suns ultraviolet radiation and extreme daily temperature
fluctuations;
Serve as living environments that provide habitats for birds and
other small animals;
Offer an attractive alternative to traditional roofs, addressing
growing concerns about urban quality of life;
Reduce noise transfer from outdoors, and
Insulate a building from extreme temperatures, mainly by
keeping building interiors cool in summer.
Mitigation: Although the Green Roof concept can be adapted only to a
limited extent for a hospital building, which has to place equipment on
rooftops, features have been incorporated into the project design to
benefit from this concept.
8.4.3 Sustainable Building
Sustainable buildings are now a buzzword in the field of architecture,

which is the driving force behind built environment and building designs
that either help the environment or harm it. The concept of Sustainable
Building is rather akin to Green Building and rests on three principles:
firstly, economising resources by curbing use of non-renewable ones;
secondly, it underscores difference between the life cycle of a sustainable
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building and that of a conventional one, and thirdly, Human Designs

tap into the individual or collective requirements to determine how
liveable a sustainable design space can be. The basic precept is that of
materials salvage from buildings that have outlived their usefulness for
reuse in prospective projects. The following issues arise:
Energy: Buildings require constant flow of energy for
continued operation. Obviously each building does not have its
own power source. Accordingly, power plants, whether coal,
nuclear or hydro-electric, are needed to provide needed energy.
Every type of energy source has drawbacks, with a common
constant of environmental impact caused. The degree of impact
may be different: coal and oil power stations cause much
pollution in the atmosphere, whereas hydro energy requires
dams and reservoirs to be built, thereby leading to severe
repercussions in local ecosystems;
Water: Daily human activities require large quantities of water
for the purposes of drinking, washing, cooking and cleaning etc.
While provision of water consumes energy, a major problem,
especially evident in Pakistan, is discharge of sewage water that
must be treated, but rarely ever is, and
Materials: There is always influx of building materials into a
project site. Waste generated after initiation of the construction
process is significant. Consumer goods which are vital for
normal human activities also pass through the building, and as
such they are all eventually an output. Either recycling or
transport to a landfill is necessary for disposal of such waste.
Sustainable design requires consequences of the life cycle of architectural
resources to be taken into account, which revolves around procurement of
resources needed to construct the project, and their final destination when
the building is demolished. This approach to the life cycle of the building
can be developed into strategies that help minimise environmental impact
as a result of its design, construction, operation and disposal and relate to:
Pre-building: Environmental consequences of the structures
design itself should be open to review, as should its orientation
and landscape impact. The manner in which materials are
procured is easily disregarded as unnecessary. The truth is,
however, that this factor has the most serious potential
repercussions. For example, harvesting of wood could result in
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deforestation, mining of natural ores and minerals disturbs the

natural status quo and even their transport adds to pollution.
Many of these materials require energy for manufacture;
Building: After construction, long-term health effects on the
buildings occupants remains to be considered. The construction
process itself should be efficient and environmental impact as a
result of the resource consumption should be limited wherever
possible, and
Post-building: Eventual demolition of the building after it has
passed its operational life span leads to the question of disposal
of construction waste left behind. Ideally, waste is recycled to
become construction material for newer projects.
While economy of resources and life-cycle design are concerned with
conservation and efficiency, humane design is based on the liveability of
virtually all constituents in global ecosystem, plants and wildlife, for
instance. Building a metropolis in the heart of the African Serengeti
without disturbing the ecosystem will perhaps never be possible, but there
are great strides that can be taken by endeavouring to preserve natural
conditions in and around buildings. The following three strategies derived
from the principle of humane design focus on creating compatibility of
buildings and the greater environment, as well as between buildings and
their occupants:
Preservation of Natural Conditions: Existing topography,
plants and wildlife are all subject to negative influences of a
building. An architect should seek to minimise the buildings
impact on the ecosystem;
Urban Design and Site Planning: Modern day hubs of human
habitat emanate large amounts of pollution. Cooperative
planning can reduce energy and water demands so as to benefit
neighbourhoods, cities and indeed entire regions, and
Human Comfort: An essential role of architecture is to provide
built environments that sustain occupants safety, health,
physiological comfort, productivity and psychological wellbeing. Sustainable design need not preclude essentials of human
comfort.
Mitigation: Modern architectural planning relies heavily on the newlydeveloped concept of sustainable building. As has been explained in
various sections of the report, various aspects of sustainable building
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have been built into the project design and cover energy conservation,
energy-conscious site planning, insulation, on-site reuse of water,
economy in water consumption, sizing of the building and various
accompanying systems properly, use of maximum possible reclaimed or
recycled materials, appropriate disposal of liquid and solid waste, and a
design that is based on anticipated life-cycle of the planned structure.
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9.
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SOLID WASTE MANAGEMENT PLAN
Domestic and commercial solid wastes include all non-gaseous, nonliquid wastes resulting from the wide range of community and
commercial activities. Effective solution to problems of solid waste
collection, treatment, conversion, reuse and disposal, are basic necessities
from the perspective of sound public health. Otherwise, indiscriminate
dumping of solid waste within the limits of populated areas can cause
severe health hazards and at the same time impact on aesthetics. The
amounts of solid waste generated by a community depend upon its socioeconomic characteristics. Generation of per capita solid waste is on the
rise on account of social, economic and technological changes. Solid
waste in Pakistan generally comprises plastic and rubber, metal, paper
and cardboard, textile waste, food waste, animal waste, leaves, grass,
straws and fodder, bones, wood, stones, excreta and fines to various
extents.
Findings of a study conducted by the Pakistan Environmental Protection
Agency in cooperation with the Japanese International Cooperation
Agency in October 2004 state that about 55,000 tons of solid waste is
generated each day in urban areas of Pakistan and only about sixty
percent is collected by municipal authorities.1 Solid waste generated at
the hospital shall be substantial, and both project development and
operation will lead to large quantities of waste. Besides being an eyesore,
solid waste can also pose serious health hazards if disposal is either
absent or is improper. Sukkur has no landfill facilities and garbage is
invariably dumped in open spaces by the public and outside the city by
municipal authorities in improvised garbage dumps where there are no
arrangements for segregation of waste, compaction or run-off control.
Environmental impact of poor waste management not only at a site or a
project in operation or within or outside an urban centre can be
categorised into two groups, namely impact due to poor waste disposal
practices, and stress on natural resources due to excessive waste
generation. Impacts caused by poor waste disposal practices include:
Exposure of waste collectors and municipal administration to
potentially hazardous stockpiles if hazardous waste is mixed
with municipal waste. Waste collectors and municipal
employees handle hazardous waste without proper personal
protection clothing or equipment;
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Pollution of water resources, contamination of soil, and

generation of hazardous fumes from uncontrolled and
inappropriate disposal of hazardous waste;
Nuisances such as odours, flies, mosquitoes and rats and
rodents;
Health issues due to provision of breeding ground for disease
vectors;
Effects on aesthetic qualities of an area due to scattered, and
airborne trash, and
Blockage and consequent overflow of drains and sewers due to
indiscriminate dumping of solid waste.
Excessive waste generation results in stress on natural resources. Any
production process requires fuel, electricity, land, water, chemicals and
other mineral or agricultural inputs. Pressures on these resources can be
minimised if production of unnecessary goods is avoided, for instance by
using substitutes that are environmentally sound. This can also be
achieved by maximising recycling and reuse of materials, promoting
products and practices involving less use of natural resources, especially
non-renewable resources. Proper and environment-friendly disposal of
solid waste requires development of scientifically-designed landfill sites
with by-product features. Even though large parcels of land, which itself
is a vital natural resource, are required for landfills, this land is later
reclaimed and green-topped when the landfill is exhausted. However,
minimisation of solid waste at the same creates less demand for such
landfills. Impact of solid waste from the proposed project will depend on
the quantity of waste generated, nature of such waste, arrangements for
disposal and receptors in the surrounding areas. As it is desirable to
prevent any significant impact, a waste management plan must be
developed for all phases of a project. Such a plan, when developed and
implemented in earnest, will be the main tool to avoid any significant
adverse impact from solid waste. Potential source of waste from
construction activities include but are not necessarily limited to:
Vegetation (grass, brush, shrubs, trees etc.) removed to clear the
land;
Cardboard and paper (packaging, office waste, cement bags
etc.);
Wood (lumber, planer waste and scrap, scaffolding waste,
packaging crates etc.);
Masonry and ceramics;
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Excess construction materials (aggregate, bricks etc.);

Metal (scrap, containers, tins, cans, bottles, workshop waste,
galvanised iron wires, steel bars etc.);
Plastics (containers, bottles, wiring, bags, sheeting etc.);
Styrofoam (containers, roofing etc.);
Glass (electric lights, bottles, packaging, window pane waste
etc.);
Insulation materials;
Excess soil and sand;
Organic waste (kitchen waste);
Waste oil and grease;
Chemicals and paints;
Batteries (lead batteries, dry and rechargeable cells etc.);
Cotton and textiles (oily rags, cleaning cloths, rags etc.);
Contaminated soil;
Electric cables, and
Clinic and medical waste.
It is anticipated that this solid waste during operation would consist of
mainly the following:
Organic waste (kitchen waste, leftovers etc.);

Newspapers, magazines, and paper;
Cotton and textiles, rags;
Floor sweepings;
Cardboard and thick paper cartons;
Wood packaging;
Disposable paper plates and cups;
Various other forms of packaging;
Medical waste, including expired medicines;
Laboratory wastes;
Used office supplies (toners, typewriter ribbons etc.), and
Obsolete office appliances (printers, facsimile machines,
computers, monitors and computer accessories).
Considering the purpose for which the proposed building is to be

employed, solid waste generation will be in the range 0.5 kg to 0.8 kg per
capita per day, following the yardstick for solid waste generation in urban
centres. Assuming total presence of an average of about twenty-two
hundred and five people per day generating solid waste, including
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patients, employees and visitors, minimum quantity of solid waste

generated is indicated in the following table.
TABLE 46: SOLID WASTE GENERATION
Persons Using the

Premises
Hospital employees
(doctors and staff)
Indoor patients
Outdoor patients
Patients visitors
TOTAL:
Hospital employees
(doctors and staff)
Indoor patients
Outdoor patients
Patients visitors
TOTAL:
Number
Number
Reduced for
Time Spent
at the
Premises
Minimum
Solid Waste
Generated
Per Capita
Per Day
Total Solid
Waste Per
Day
605
200
1,000
400
2,205
202
200
42
17
461
0.5 kg.
0.5 kg.
0.5 kg.
0.5 kg.
0.5 kg.
101 kgs
100 kgs
21 kgs
8.5 kgs
230.5 kgs
605
200
1,000
400
2,205
202
200
42
17
461
0.8 kg
0.8 kg
0.8 kg
0.8 kg
0.8 kg
161.6 kgs
160 kgs
33.6 kgs
13.6 kgs
360.8 kgs
The above table indicates that the maximum amount of solid waste that
can be generated per day at the rate of 0.5 kg per capita per day is 230.5
kgs. If per capita per day waste generation rate of 0.8 kg is to be used,
waste generation will be 360.8 kgs.
Mitigation: Following measures shall be adopted for minimisation of
solid waste and appropriate disposal:
The proponents shall engage a waste management contractor for
disposal of solid waste during all phases of the project;
The appointed waste management contractors shall be bound
contractually to dispose of solid waste carried from the premises
in an environment-friendly manner, both during transit and at
the time of final disposal;
Employees, patients and visitors shall be encouraged to use the
garbage chutes for waste disposal to ensure speed in disposal
and so that there is no littering around the hospital;
In procurement of supplies for the project, the size and nature of
packaging shall also be taken into consideration;
Wherever possible, packaging shall be returned to
manufacturers for reuse;
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Solid waste received through the garbage chutes shall be kept

temporarily in the basement before it is removed for further
disposal;
All solid waste shall be stored in large bins on a temporary basis
at the north-eastern rear side of the plot from where it shall be
removed on regular basis through the appointed waste
management contractor;
All solid waste will be segregated appropriately for safe
disposal;
The proponents shall encourage all people present at the
hospital to reuse paper to the extent possible;
Bins shall be placed around the compound and within common
areas to collect solid waste and all patrons shall be advised
through smart notices to place waste in dedicated bins and not
through it indiscriminately;
Signs shall be posted in washrooms and kitchen advising
minimisation of solid waste, and
Special attention would be paid to solid waste that can be
recycled. All recyclable solid waste shall be kept separate for
disposal through special arrangement with recycling industries
and contractors that collect such solid waste for onward sale to
industries engaged in recycling and production of environment
friendly products.
A Waste Management Plan indicating liquid and solid waste disposal
methods is placed overleaf in tabular form. Despite rather large volume of
solid waste that is likely to result from project operations, the proponents
do not need to develop their own landfill.
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10. TRAFFIC IMPACT ANALYSIS

Based on yardsticks adopted by most building control and development
authorities, one car parking space must be provided for every one
thousand square feet of covered area, excluding basements, in a
commercial building. There is no such stipulation in respect of hospitals.
The basement has been earmarked for car and motor-cycle parking and
there shall be eighty bays for cars and three hundred and twenty spaces
for motor-cycles. In addition, there shall be plenty of spaces shall be
available at the building front and sides for temporary parking. The front
of the hospital shall be used purely for temporary parking of visiting
patients and ambulances. Availability of parking spaces in the basement
floor and ground level is shown in the following table.
TABLE 48: PARKING ARRANGEMENTS
Parking Area
Basement
Open areas
Spaces for Cars

80
1,000
Spaces for Motor-cycles

320
1,700
Source: Submission Drawings
The basement shall be used purely for vehicle parking, and for designated
purposes as described in the approved building plans. The basement shall
have fire cabinets, staircases, elevators, security desk, air plenums and
full-height louvers, utility rooms etc., and facilities for drivers. The width
of the ramp shall be between 3.7 to 4 metres with 2.1 meter clearance and
gradient of 1:8 to 1:10. The parking floor shall be well lit with fluorescent
markings on the floors demarcating direction of traffic and exits. There
shall be clearly marked bays, disabled parking, sufficient room for
positioning and reversing of vehicles, and rubber padding along the walls
for fender protection. The basement shall have double driveways with a
minimum width of 196 feet.
10.1 INCREASES IN VEHICULAR TRAFFIC
There shall be increase in vehicular traffic in the project area and around
the project site as construction commences. These vehicles could possibly
include mobile cranes, excavators, bulldozers, tractors, graders, scraper,
rollers, dumpers and loaders, wheel loaders, tower crane, heavy duty
vehicles, drilling vehicles, trenchers, forklifts, water tankers and jeeps
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and cars for project supervisors and engineers. The exact number of such
vehicles shall vary according to the pace of construction. However, using
the rule of thumb for projects of such size, there shall be a maximum of
five to ten vehicles visiting the site per day at the peak of construction.
Table 50 is an indication of anticipated traffic during the project cycle.
The proponents will instruct the construction contractor to ensure that
least possible disturbance is created at the site from operation of
construction vehicles. Measures to reduce disturbances shall include:
Construction vehicles will not be parked on private properties or
where they can cause impediments to local traffic;
Construction vehicles will not park or queue up on any road
close to the project site;
All vehicles carrying construction materials and supplies shall
reach the site from main roads and these vehicles will not thus
affect local traffic or pass through populated areas unless
unavoidable ;
Drivers of these vehicles will be barred from blowing horn at
the project site or on the roads;
Drivers shall follow traffic protocols and road courtesies, and
It will be ensured that all such vehicles are properly tuned and
in good working conditions and have quality mufflers installed
in order to reduce vehicular noise.
Traffic counts at the project site are shown in the following table, which
are indicative of low to medium traffic activity typical of a small urban
centre. Considering traffic volumes at the project site, there will be
negligible increase in vehicular traffic on account of construction-related
vehicles when construction commences. The exact number of such
vehicles shall vary day to day.
TABLE 49: TRAFFIC COUNTS AT PROJECT SITE
(No. of vehicles during a one hour period)
Location:
Sukkur Bypass (in front of
the project site)
0700-0800
hrs.
1100-1200
hrs.
1400-1500
hrs.
1830-1930
hrs.
1,023
1,163
1,241
982
Source: Traffic Count Conducted by Environmental Consultants on August 21, 2011
Mitigation: Traffic counts shown above exhibit low to medium volumes

of traffic at the proposed project, which would mean that the impact of
project-related vehicular activity on local traffic shall be extremely
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negligible. Traffic Police will be approached to obtain counsel for

movement of vehicles carrying equipment and construction materials to
the project site. It will be ensured that such movement takes place during
off-peak hours or on holidays and never at night. The proponents shall
instruct the contractor to the effect that least possible disturbance is
created at the site from operation of construction vehicles.
10.2 TRAFFIC AND
TRANSPORTATION MANAGEMENT PLAN
There shall be sufficient parking within the basement and at the ground
level for the quantum of traffic expected at the proposed hospital, which
is a major factor of mitigation from the viewpoint of vehicular activity
resulting from the project. The project site faces the forty feet wide
Sukkur Bypass, which thus has sufficient capacity to absorb the impact of
additional traffic expected from project implementation and operation.
Traffic count in Table 49 included all mechanical vehicles, such as cars,
buses, trucks, vans, rickshaws and motor-cycles etc., and did not include
bicycles or other forms of non-mechanical traffic. Based on traffic count
for Sukkur Bypass, the average number of vehicles plying on this road on
a working day comes to about 1,102 per hour or 26,454 per day. It is
impossible at this stage to assess how many vehicles shall frequent the
hospital during a day and how long they shall remain at the premises. An
accurate traffic count can only be taken when the project is in operation
and only an estimate based on various assumptions can be attempted at
this stage of the project. Secondly, there is no scientific yardstick to
determine how many times the vehicles of regular employees shall enter,
leave and re-enter the premises. Thirdly, the exact number of patients
visitors depends on the profile of the patient.
The starting point to calculate additional traffic load as a result of the
operation of the hospital is the number of parking spaces in the building.
The design for the building caters for one thousand and eighty parking
spaces for cars, and two thousand and twenty parking spaces for motorcycles within the basement and in the open areas, which can be assumed
as the least number of vehicles that shall enter or leave the compound at
least once during a day. At this stage of the proposed project, it cannot be
stated whether these spaces will actually be used in full when the project
comes into operation. These vehicles cannot be expected to occupy
parking spaces throughout the day and it can be presumed that some
vehicles shall leave the compound and re-enter once, twice or many times
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over during a single day, as some visitors may come again and again. As
for employees, one could rely on the rule of the thumb, which states that
every employee leaves a work place to return at least once a day,
offsetting people who dont step outside as also employees that come and
go. To this we must add a ten percent cushion to account for errors. This
would, however, give us an arbitrary number based on assumption alone.
Then the question arises as to how many visitors there shall be at the
hospital during a normal day. There is no way to predict the number of
visitors per day at this stage of a project and an accurate count can be
made only when the project comes into operation.
The best way to estimate the number of visitors at a building compound,
whether it is a hospital or an apartment complex, and the number of times
that employees leave and come back, is to take a traffic count at existing
projects of similar nature. However, there are no workers hospitals
anywhere in the province in a city of a similar size that can be tested for
traffic counts and a comparison with social security hospitals in Karachi,
for example, would not render accurate results due to differences in
patients profiles. Accordingly, the management consultant has worked
out possible vehicular activity during a normal working day at the
proposed hospital in Table 51 after consultation with doctors, hospital
employees and parking contractors, and based further on the following
broad assumptions:
There shall be about six hundred and five permanent employees
at the proposed project;
Doctors and senior staff shall frequent the compound using
transport at the rate of 1.25 times per day;
Hospital employees usually work in shifts and shall use
transport to reach or leave the hospital only once;
Each employee shall have a vehicle in some form;
Even if an employee does not have a vehicle, he shall use
locally available means of transportation, and the demand for
such transportation will increase correspondingly;
The total number of visitors per day, excluding delivery
services, shall be about four hundred, using at an average three
hundred and thirty-three vehicles;
Visitors shall make an average of 1.5 visits to the hospital per
day, and
There shall be at an average of roughly ten service vehicles per
day.
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TABLE 51: ESTIMATED VEHICULAR ACTIVITY
Number
of parking spaces
Number of senior staff
Estimated number
of senior staff
vehicles
Number of hospital
employees
Estimated number
of hospital employees
vehicles (including
public transport)
Estimated number
of visitors per day
Estimated number of
visitors vehicles
(including public
transport)
Service vehicles
TOTAL:
Number
Frequency
of
Visits to
the
Hospital
Number of
Vehicles at
the Premises
Number of
Vehicles Per
Hour
2,400
120
-----
-----
-----
114
1.25
143
485
---
---
---
364
364
15
400
---
---
---
300
10
---
1.5
1
---
450
10
967
19
0.4
40.4
Source: Consultants Estimates
Hourly traffic average on Sukkur Bypass is presently 1,102 vehicles. The

above estimates indicate that hospital activities shall add about nine
hundred and sixty-seven vehicles to the traffic count of Sukkur Bypass, or
about 40.4 vehicles per hour, which would be an increase of about four
percent only. After accounting for round trips, total traffic impacting on
Sukkur Bypass shall be nineteen hundred and thirty-four per day or
eighty-one per hour and percentage impact would be about seven and a
half percent. The following measures shall be taken by the proponents to
manage additional traffic from operation of the proposed project:
Security guards shall make sure that vehicles leaving the
compound join traffic on Sukkur Bypass in an orderly manner
and do not obstruct oncoming traffic;
Employees arriving on public transport shall not insist on being
dropped in front of the hospital and shall alight at designated
bus stops;
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Employees shall be under strict instructions not to blow horn

indiscriminately;
Visitors shall be encouraged to park their vehicles within the
compound so that there is no car parking on Sukkur Bypass;
Taxis shall not be permitted to linger or loiter outside or close to
the hospital entrance;
Employees shall be encouraged, through circulars and notices,
to keep their vehicles tuned so that these vehicles do not
generate unwanted emissions in and around the premises;
Employees shall also be encouraged to pool vehicles in order to
curtail number of vehicles that frequent the hospital on a
permanent basis;
Similarly, security guards shall regulate incoming traffic in such
a way that vehicles intending to enter the compound do not
create any traffic congestion on Sukkur Bypass, and
In order to facilitate the above, vehicles belonging to employees
shall be provided with stickers so that stickered vehicles are
flagged through into the compound or into the basement without
any delay.
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11. SECURITY AND EVACUATION PLAN

An Environmental Impact Assessment must also incorporate a
contingency plan to meet emergencies and security situations for
buildings where there is likely to be a large deal of public dealing or
where there will be constant presence of people.
11.1 SECURITY
Security of premises and employees must be of primary concern to the

proponents, especially to ensure that unauthorised people do not enter the
compound and interfere with service delivery.
Mitigation: The following steps shall be taken to maintain security at the
hospital:
The proponents shall ensure that all employees are issued
identity cards and entry passes;
All visitors shall pass through security gates and would be
manually scanned with metal detectors by security guards;
Briefcases and handbags or any other form of baggage shall be
similarly scanned or put through X-ray machines;
A security protocol shall be evolved to monitor identity, arrival
and departure of each visitor;
The proponents shall install closed circuit television system for
sensitive parts the hospital and immediate surrounding areas,
with security cameras on all floors and basement, entrances and
exits. A fully-equipped Communications Room shall be
designated for round-the-clock surveillance and monitoring of
premises;
There shall be a pole barrier at main entrance, supplemented
either by road blockers or rising step barriers, in addition to
scanners that can survey undersides of vehicles entering the
compound. Entrance and exit of the ramps to and from the
basement shall similarly have pole barriers, preferably
supplemented by rising step barriers in order to avert not only
unauthorised parking but also vehicle theft, and
Access to basements would be regulated through a parking
ticket dispenser activated with a smart-card.
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11.2 EMERGENCY AND FIRE-FIGHTING PROTOCOLS
There are estimated to be a large number of people in the building at peak

visiting hours. A structure of the size of the proposed project would be
susceptible to a fire hazard and other emergencies. Therefore, appropriate
protocols would be employed to reduce risks and manage emergency
situations.
11.2.1 Fire-fighting Regimes
The building regulations of the District Government specify that every

new building must be provided with sufficient means to extinguish fire.
Mitigation: This mandatory provision has been complied with by the
architectural planners and incorporated into the building design. The
proposed fire strategy is based on the American National Fire protection
Association (NFPA) Life Safety Code (NFPA 101). The design and
specifications of the actual fire protection measures are based on British
and European standards. The system is based on the following elements
that will be provided at the hospital to meet requirements:
Means of Escape: Means of escape shall be provided on all
sides and parts of the building, including parking basement.
Capacity and design of escape follows the National Fire
Protection Safety criteria and design capacity of various
components of the building;
Staircase Protection: Staircases shall have fire-proof doors and
have been designed to ensure that they remain smoke-free;
Sprinklers: Sprinkler system shall be installed throughout the
proposed building;
Smoke Clearance: Smoke clearance system will include high
capacity impulse fans;
Fire Alarms: There shall be fire alarms in all parts of the
building;
Emergency Lighting: Emergency lighting, particularly geared
for smoke, shall be available throughout hospital at all levels;
Fire Detection System: Smoke detectors shall be fitted in all
hospital rooms and common areas of the hospital, as also in the
basement, and
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Elevators: Elevators shall conform to fire-fighting emergency

operations and requirements.
The building shall be equipped with adequate fire-fighting measures in
the form of fire-escapes, sets of fire extinguishers, fire-resistant clothing,
fire-fighting buckets filled with sand or fire-repellent substances, smoke
alarms, smoke detectors and fire-hose reels on all floors. There shall be
smoke detectors and fire alarms inside each hospital room. A sprinkler
system is a vital component of the fire-fighting regime and would be
centrally-controlled and trigged in the event of excessive smoke typical of
a fire incident. The fire-hose reels shall have length sufficient to cover the
entire length of the floor. The fire-hose reels will be connected with firehydrants through pipes with appropriate diameter so as to provide
effective pressure and discharge of water for fire-fighting. There shall be
at least two fire hydrants on each floor to connect with the fire-hose reels
and a minimum level of water shall be maintained at all times in the water
tanks to be available for fire-fighting purposes. There shall be at least
four fire hydrants within the compound and two at the exterior. All
openings to staircases shall be enclosed with fire-proof doors so as to
contain possible blaze(s) within the fire area and also to provide safe
passage at evacuation.
A smoke clearance system using high capacity impulse fans would also
be employed. Emergency lights shall turn on whenever the fire alarm is
triggered for facility of people attempting to leave the premises. The
elevators shall be disconnected automatically at the time of fire
emergency signalled by a fire-alarm. Under standing government
instructions, smoking is not allowed within public buildings and the
proponents shall ensure enforcement of the smoking ban, which shall
reduce the risk of fire. Inspections shall also be carried out frequently to
check electricity wires and mains, office equipment and machinery, such
as generators, air-conditioning plant and water pumps to eliminate
possibility of fire through equipment malfunction.
11.2.2 Fire Drills
In addition to safety features within the project design, people using the
premises should also be aware of safety precautions and protocols.
Mitigation: The proponents shall impart training to selected employees
to launch safety measures at the time of emergency. Such employees shall
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don fire-resistant clothing available on each floor prior to initiate

evacuation protocols. The proponents shall organise fire drills at least
once a month to keep employees familiar with procedures to be adopted
at the time of a fire emergency and to test alertness of selected
employees. Smoke detectors and fire alarms shall be tested at least once
every fortnight to test whether these are functional. Frequent inspections
shall be conducted on the instructions of the proponents to ensure that
smoking ban is being adhered to. Finally, all electric installations shall be
inspected regularly to prevent malfunction and short-circuiting.
11.2.3 Evacuation Plan
Similarly, employees should be aware of actions to be taken during

evacuation from the premises in an emergency situation.
Mitigation: Guidance notes shall be placed on the inside of all doors to
inform people about exit points from the building in the event of fire or
other similar emergencies. Installation of closed-circuit television, to be
powered by standby batteries when electricity supply is cut off, will
greatly facilitate evacuation from the hospital. Accordingly, the
Communications Room shall be located in such a way that evacuation
procedures can not only be observed but evacuation for staff is also
convenient. The Communications Room surveillance-cum-monitoring
room shall also have a backup source of power so that the building can be
properly scanned when power supply is cut off. Personnel on duty shall
cover all aspects of evacuation and monitor exit from the building. As
stated earlier, selected employees will be provided mandatory training to
use fire-fighting apparatus in case of a fire emergency.
Such Emergency Coordinators shall immediately wear fire-resistant
clothing, in case of a fire, and supervise evacuation procedures. Smoke
detectors shall trigger fire alarms. In case smoke detectors fail to engage
the fire alarm, it would be possible to engage fire alarm manually. The
fire alarm at the same time shall be subject to failsafe to prevent from
being operated accidentally. On engagement, fire-alarms will release a
loud klaxon warning to alert people present in the hospital, as also
everyone outside to ensure that no one enters the premises. Fire-proof
clothing for at least one employee will be available on each floor in
closets next to fire-stations. At the time of a fire emergency, which shall
be sounded by fire alarm klaxons, designated Emergency Coordinators on
each floor shall wear fire-proof clothing and guide people to nearest exits.
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Elevators will be immediately vacated and disconnected from electricity

mains in case they have not been disconnected in unison with fire alarms.
Fire hose reels shall be activated and Emergency Coordinators will
engage all portable fire-extinguishers to arrest the blaze as much as
possible or to put the fire out. At the same time, communication shall be
made with the Fire Brigade and hospitals for urgent support. All fire
proof doors shall be closed immediately after complete evacuation to
contain the fire. Access to fire-escapes, which shall be clearly marked,
shall be provided at all upper floors, and would be conveniently accessed
through large windows or doors. Staircases shall be enclosed with fireproof doors so as to contain possible blaze(s) within the fire area and also
to provide safe passage at the time of evacuation. Procedures to be
followed and escape routes to be used will be clearly displayed at each
floor. Arrows in fluorescent ink will delineate fire-escape routes on each
floor and the stairs. In short, all fire-emergency measures prescribed
under the building regulations shall be adhered to strictly. Similar
protocols shall be devised to put the Evacuation Plan in force in case
there is some other form of emergency necessitating evacuation from the
building. There shall also be at least two clearly marked emergency
telephones on each floor, including the basement, which shall connect to
the Control Room. There shall be dedicated lines to handle emergency
calls and telephone operators shall be under instructions to put all calls on
hold to attend to emergency calls. The proponents shall devise a standard
operating procedure to be followed in the telephone exchange in this
behalf. The location of the telephone exchange should also be such that
evacuation is unimpeded, convenient and swift, and would preferably be
within the Control Room.
11.2.4 Other Emergencies
Emergency Coordinators shall also be trained to act in case of other

emergencies, such as earthquakes, epidemic, pest attack or terrorist
activity, and shall follow protocols defined within the evacuation plan.
Fire alarms can be activated to signal evacuation. The proponents shall
devise a list of all possible emergencies and prescribe reaction, response
and evacuation procedures for all such contingencies. In any case,
instructions are issued from time to time by federal government agencies
to either prepare plans for meeting emergency situations or to follow laiddown procedures.
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12. ENVIRONMENTAL MONITORING

Environmental testing at a project site is essential not only during project
implementation but also prior to launching of the project and after the
project comes into operation, in order to gauge whether any aspect of the
project has interfered with the local environment.
12.1 ENVIRONMENTAL TESTING
Environmental testing was carried out according to the following

sequence:
TABLE 52: ENVIRONMENTAL TESTS
Date (s):
Tests:
June 2011
Soil
September
13, 2011
August 21,
2011
August 21,
2011
Water quality
Traffic
congestion
Noise
Source:
Geo-technical
Consultants
Environmental
Consultants
Environmental
Consultants
Environmental
Consultants
Laboratory:
Geo Project Consultants
Public Health
Engineering Department,
Govt. of the Punjab
N.A.
Hand-held apparatus
Results of various tests conducted are discussed briefly in the following

sub-sections.
12.1.1 Soil
Tests ascertained that the quality of the soil was good and did not contain
any infirmities requiring use of special building materials. The soil was
found to be sturdy enough to take the load of the proposed structure.
12.1.2 Water Quality
Ground water sample was collected from existing source at the project
site and subjected to tests to determine quality. The water was found
chemically fit for direct human consumption.
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12.1.3 Traffic Congestion
A traffic count was taken in the project area to work out possible effects
of project operation on local traffic. Impact of project operations traffic is
discussed in detail in Chapter 10 relating to the Traffic Impact Analysis.
12.1.4 Noise
Noise samples were taken at various locations and it was found that noise
levels are a maximum of 66 dBA in the immediate project area.
12.1.5 Conclusions of Environmental Monitoring
All tests carried out in connection with environmental monitoring of the

project site have revealed that implementation of the project is not likely
to impact adversely in any manner whatsoever on the local environment.
12.2 ENVIRONMENTAL
MONITORING DURING PROJECT EXECUTION
Environmental Monitoring shall continue during the course of execution

of the project in accordance with specified time-frame and conditions of
environmental approval to be issued for the project.
12.3 POST-PROJECT MONITORING
Two aspects of this environmental study require attention of the

proponents. Firstly, it shall be incumbent upon them to ensure effective
and complete implementation of the Environmental Management Plan,
which provides appropriate mitigation measures during the design,
construction and operational phases of the proposed project. Secondly, it
shall also be required of the proponents to monitor environment at the
hospital when it comes into operation in order to fathom whether project
operations are impacting adversely on the environment.
Mitigation: Accordingly, the proponents shall have to evolve a protocol
so that monitoring is regular, meaningful and consistent. The proponents
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should nominate the Waste Management Team to be appointed in

compliance of Rule 4 of the Hospital Waste Management Rules, 2005, to
carry out environmental monitoring of the hospital and the
neighbourhood. The Waste Management Team should be entrusted the
following charter of duties:
Implementation of all conditions contained in the environmental
approval to be issued by Sindh Environmental Protection
Agency;
Environmental monitoring within the hospital and the
neighbourhood;
Maintaining security of premises;
Checking safety protocols within the building, and
Submission of requisite information and reports to the hospital
administration and Sindh Environmental Protection Agency.
The proposed Team shall also need to be allocated a reasonable budget to
commission environmental testing periodically and thereafter report
findings to Sindh Environmental Protection Agency. An annual amount
of Rs. 780,000 shall be required for environmental monitoring during
operation of the project, as calculated in the Environmental Monitoring
Programme at the end of this chapter. The Waste Management Team will
be responsible for following aspects relating to project operation:
Maintaining liaison and relationship between the proponents,
employees, patients, patients attendants and visitors n the
context of environmental preservation;
Proper maintenance of trees, green areas and plantations within
the compound and beyond its outer limits, especially between
the building line and Sukkur Bypass;
Taking stock of efforts made to contribute towards plantations
in adjoining areas;
Enforcement of measures aiming to reduce solid waste within
the hospital and its compound;
Assessing arrangements for collection of solid waste;
Ensuring segregation of solid waste to separate hazardous
waste, if any, recyclable waste, green waste and non-recyclable
waste;
Ensuring appropriate storage of all forms of segregated waste;
Ensuring disposal of all forms of segregated waste in an
environmental-friendly manner;
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Direct supervision of incineration processes and regular

maintenance of the incinerator;
Ensuring that all obsolete equipment and machines are disposed
of in an environmental-friendly manner;
Appropriate conservation of water resources;
Adoption of measures for minimisation of liquid waste;
Checking measures taken to eliminate wastage of water;
Monitoring measures taken for reuse of water;
Regular monitoring of the wastewater treatment plant;
Maintaining noise levels inside the hospital building and its
compound within the levels specified under the National
Environmental Quality Standards;
Supervising annual maintenance within the hospital building;
Managing and testing safety equipment and protocols to ensure
safety within the premises;
Ensuring that vehicles owned by employees do not create
pollution and that these are kept in good working condition;
Ensuring that the basement is used only for parking of vehicles;
Conducting environmental testing, through a certified
laboratory, both inside and outside the hospital to measure
ambient air quality, noise levels and groundwater quality and
checking emissions of employees vehicles;
Checking worthiness of fire-fighting equipment, and
Conducting fire-drills a least once a month.
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13. SOCIAL IMPACT ASSESSMENT
The project is outside the city on an unencumbered plot. Accordingly,

there are no social issues arising out of land acquisition proceedings and
dislocation of authorised or unauthorised users of the project site. Public
consultation was carried out and a social survey was undertaken to assess
public perceptions about the project and whether mitigation measures are
necessary and if these shall be enough.
13.1 PUBLIC CONSULTATION
Public consultation is an important element in establishing environmental

parameters of a development project and an environmental impact
assessment would be incomplete without eliciting views of primary
stakeholders, i.e. people directly affected by project implementation and
operation. In case affected public is educated and well-informed, it will
not only be aware of benefits and disadvantages of the project but can
also be convinced of advantages of trade-offs. Public consultation is thus
designed essentially to allay fears of affected population about the project
and to inform them of direct or indirect benefits, not only for the project
area but for the country as a whole. The rationale for consultation can be
summarised as under:
Inform stakeholders about salient features of the project;
Document concerns of the stakeholders about the project in
order to allay their fears. This contributes to lessening any
unfounded adverse environmental impact of the project on local
communities and assists project implementation;
Compile data pertaining to the project area and collect informal
information that may have not been otherwise documented
Assess public perceptions about the project, and
Pinpoint any section of the local population that could be
particularly affected by project activities.
13.1.1 Identification of Stakeholders
Fieldwork and public consultation was designed to identify stakeholders.

On the basis of findings of the field team, primary stakeholders are:
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Close neighbours;
Local businesses, such as drug stores, clinics etc.;
People who shall benefit from project activities in the form of
employment or business opportunities;
Government departments directly or indirectly involved with
the project, and
Knowledgeable residents of the area keen to contribute to the
consultation process.
13.1.2 Consultation Process
Discussions were held with a number of government departments to

gather information about the land and the people, public-sector
infrastructure, possible impact, if any, of project activities on the
surrounding environment and any private or public concerns about the
project under review. Consultation was held with following offices of
District Government or the Government of Sindh:
Deputy District Officer (Coordination);

Hyderabad Electric Supply Company;
Conservator of Forests;
Divisional Forest Officer;
District Social Welfare Office;
Works & Services Department;
Executive District Officer (Health);
Traffic Office;
Deputy District Officer (Revenue);
Wildlife Department;
Directorate of Labour;
Executive District Officer (Education), and
Other stakeholders listed in the previous sub-section.
Locations of public consultations, along with dates, are shown in Table

54 overleaf.
13.2 SOCIAL IMPACT ASSESSMENT AND SURVEY
Surveys were conducted twice to collect stakeholders views about the

project. Results of the social survey are indicated in Table 55 overleaf.
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There was no alarming concern about the proposed project amongst local
residents, while most stakeholders were satisfied with the proposal. A
number of doctors however were generally sceptical about the project on
the ability of the proponents to maintain the desired standards.
13.2.1 Social Survey Methodology
The following methodology was adopted to conduct the social survey,

which was carried out by two separate teams:
Local students were engaged to conduct the survey;
People interviewed were selected at random;
While conducting the interviews, it was ensured that a crosssection of the public is covered by the survey;
People selected for interview were chosen carefully to ensure
that only knowledgeable individuals were approached for
views;
No extraordinary discrimination was exercised in selecting
people to be interviewed and the questions were directed not
only at educated people alone;
Questions were simple and direct and properly explained in
order to remove distortions in sampling;
People interviewed included patients at local hospitals, medical
students, local doctors, staff at hospitals, leading workers
representatives, government servants, businesses, and
All interviewed were briefed about the project under review, in
case unaware of impending project activities.
People desirous of seeking information about potential benefits of the
project were briefed on the number of jobs that would be created during
construction and operation, volume of monetary investment, business
opportunities for local businesses etc.
13.2.2 Conclusions of the Social Survey
It would be observed from findings of the social survey that many of

those interviewed bore positive about the project. Feedback from those
interviewed in response to sample questions and direct questions that
were not put to everyone, is summarised as under:
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Most residents were pleased with the state-of-the-art medical

facilities that would be added to the city;
There was relief that these medical facilities would also be
available to the general public and would not be exclusively for
workers;
Patients at local hospitals were especially happy that a new
hospital with modern equipment and facilities was being
planned;
There were not many views that construction of a high-rise
building would add prestige to the project area;
There were barely concerns about intrusions into privacy of
residences and these concerns were withdrawn when it was
explained that hospital rooms overlooking the neighbourhood
do not remain occupied on a twenty-four hour or permanent
basis;
A number of residents were happy with the planned
development as it would drive up property prices in the area;
There was general satisfaction that project development had not
caused any undue hardship for the local public;
There were very few concerns regarding pollution that may be
caused by the proposed project;
There were a few concerns that traffic in the immediate area
would increase;
There were no complaints about possible noisy works from
project activities;
Chemists in the local area were especially in praise of the
project as it would not only add a new hospital but would add to
the capacity of the city to attend to medical needs of patients
throughout the district as also adjoining districts, thereby
generating business;
All doctors were appreciative of the proposed intervention but a
few commented on the inability of the public sector to maintain
highest standards of service delivery;
Medical students were unanimously pleased by the proposed
project and hoped that they would have the opportunity to be
given rounds and instruction within the proposed modern
medical facilities as exposure to modern equipment and
techniques would enhance their medical training;
Workers representatives were in full praise of the project but
expected that workers and their families should be given preemptive rights over medical facilities;
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Workers representatives also wanted that all facilities should

be free of cost;
Employees interviewed at two local hospitals appreciated the
project as it would open up employment opportunities for
experienced nurses, technicians etc.;
Government departments and government servants were
positive about the project and were of the view that the facilities
should be open for the entire public;
There were some concerns amongst government functionaries
about location of the project away from the city but many
retracted their comments when informed that the previous site
was in the heart of the city and would have added to congestion;
Most people are not disturbed by major construction works that
would follow;
There was no adverse reaction to impending movement of
construction vehicles;
Arrival of workers and supervisors would not be unwelcome;
There were concerns that not enough jobs would be offered to
locals and that workers would be brought in from outside the
project area, and
District Government officials had concerns about disposal of
solid waste and expected that the proponents would make
suitable arrangements for removal and ultimate disposal.
Since the project is yet to be launched and some prior actions can be
taken, the following suggestions were made:
The proponents, or the construction contractor, must restore
roads or paths that are damaged during project implementation;
The contractor should make sure that sufficient steps are taken
for observing privacy of residents;
Project vehicles should follow traffic laws and road courtesies;
Machinery and equipment should be moved only when there is
minimal inconvenience for local population;
All roads and paths that may be damaged should be
rehabilitated;
Construction activities should not interfere with local customs
and traditions;
Construction activities should not interfere with movement of
local traffic or pedestrians;
All labour should be engaged locally;
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Unskilled labour should be introduced to training;

Private properties should not be encroached upon;
No environmental hazards should be created at the site;
All private lands that may be disturbed during project
implementation should be rehabilitated;
The proponents must supervise the work of the contractor to
ensure that all concerns of the local population are appropriately
addressed, and
There should be appropriate disposal of liquid and solid waste.
Due to the nature of the project, it was not considered necessary to
broaden the scope of the survey beyond the questions put to those
interviewed, or to extend the survey beyond the people approached, other
than questions relating to the previous site.
13.2.3 Mitigating Factors
The social survey indicates that the sampled public is more or less
comfortable with impending construction activities. The following
arguments provide mitigation factors for the proposed project:
The proposed project will be implemented on a parcel of land
that is presently lying unutilised;
There are no natural habitats or breeding grounds for animals
and birds within this strip;
Implementation of the project will cost a minimum of Rs. 2.7
billion, which shall generate business and economic activity,
and
There are no trees or vegetation at the project site. However, an
elaborate plantation and greening programme is embedded in
the project which shall liven up the area.
13.2.4 Employment Generation
The project shall result in creation of a large number of temporary as well

as permanent jobs during the pre-project stage, implementation and
operation. Jobs to be created include assignments taken on by permanent
employees. Surveys included geotechnical investigations, topographical
survey, social survey, traffic counts, noise testing, and laboratory tests for
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water quality. The following table gives a rough but possibly accurate
picture of job creation from project activities.
TABLE 56: EMPLOYMENT GENERATION
Phase
Surveys
Studies
Designing
Construction
Supervision
Operation
Environmental
Monitoring
Type of workers
Skilled/unskilled
Skilled
Skilled
Skilled/unskilled
Skilled/unskilled
Skilled/unskilled
Skilled/unskilled
Jobs
created Permanent Temporary
15
--15
30
24
6
12
--12
400
--200
5
--5
605
605
--6
---
13.2.5 Complaint Redressal Mechanism During Construction
A major project must put in place a complaint redressal system so as to

resolve issues arising out of project implementation and to alleviate
impacts on the local environment and inhabitants, considering especially
that project implementation shall take a minimum of two years for
completion.
Mitigation: A sign shall be posted at the site regarding project activities
and a qualified project manager will be appointed to entertain or respond
to public complaints. The proponents are being advised through this
environmental report to put up a link on their website to receive public
complaints, if any, about project activities and to advertise such link
through a notice at the site. The proponents shall thereafter also establish
a complaints redressal mechanism to respond to public concerns.
13.3 MEASURES FOR SURROUNDING AREAS
The proponents will ensure that there will be no adverse environmental

impact of the construction process or project operation on surrounding
areas. However, noise and dust pollution from construction cannot be
eliminated one hundred percent and at best can only be minimised. Since
the proposed project shall not impinge on living conditions of local
residents in any matter whatsoever, there is no necessity for any special
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economic conditions of local residents or surrounding areas. Such

measures are needed in only those cases where location of a project
creates hardships for local population and surrounding areas and are
usually taken by multinationals or large industrial units in the form of
employment opportunities, hospitals, dispensaries, schools, water supply,
sanitation services and recreational facilities for local population.
Measures for surrounding areas become especially expedient as a part of
a major environmental enhancement campaign especially in case of
usually large industrial projects that can have significant off-site impacts
in the shape of emissions, solid waste generation, congestion, land
compensation or resettlement.
Mitigation: The project site shall be sprinkled frequently to minimise
dust pollution, and construction area shall be cordoned off. The
construction contractor shall use good quality vehicles, machinery and
equipment to ensure that noise and smoke emissions are within limits set
under the National Environmental Quality Standards. No activity shall
take place at the construction site that can endanger local community,
especially neighbours, or cause any undue hardship. Construction of the
hospital and subsequent operation will provide work for local workers
and generate business for commercial establishments. The proponents
could, however, consider a plantation and beautification campaign in the
immediate area of the proposed project, which will be beneficial for
project operation too. This contribution shall add immensely to improving
aesthetics of the area. It shall, however, depend greatly on the ability of
local civil society to motivate the proponents to contribute further to the
surrounding areas in various different ways when the project enters
operational phase.
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14. COMPENSATION AND RESETTLEMENT
Implementation of a project can touch on issues relating to acquisition of

land, payment of compensation for land, damages for crops, trees,
orchards, structures and other assets, and resettlement of population that
may have to be removed and relocated.
14.1 COMPENSATION
Land for the project site has been placed at the disposal of the proponents
for implementation of the project by the Government of Sindh. The site is
unencumbered and available for development. Therefore, there are no
issues involved in payment of compensation, relocation and resettlement
of authorised or unauthorised occupants of the project site.
14.2 RESETTLEMENT PLAN
A Resettlement Plan must developed by a proponent where the project

under implementation involves displacement of large numbers of the
local population. Even where displacement is not anticipated or is
minimal, the proponents must compile details of expected damages and
estimate payment of compensation requiring interventions shown in
Table 57 overleaf. Since the proposed project site is public property and
arrangements for transfer of land and its possession have been finalised
through inter-departmental meetings, a Resettlement Plan was not
required for the project under review of this Environmental Impact
Assessment.
14.3 GRIEVANCE REDRESSAL MECHANISM
Even though the Land Acquisition Act, 1894, has not been invoked for
project implementation, it would be worthwhile to mention here that it
provides a mechanism for redressal of grievances of all persons affected
from a project. Therefore, the proponents shall develop a link on their
website to record and monitor complaints of not only the dislocated
families but also from residents of the area or from any other persons
directly or indirectly affected by project implementation.
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15. CONCLUSIONS
This Environmental Impact Assessment has been conducted, to the extent

possible, in line with relevant guidelines provided by the Government of
Pakistan. The objective of such studies is to identify and assess potential
environmental and social impacts of the proposed hospital. The
Environmental Impact Assessment contains description of the project,
description of the environmental baselines, potential environmental
impacts and suggested mitigation measures. An implementation
mechanism for mitigation measures in the form of an Environmental
Management Plan is included in the study. While the objectives of this
study have been to describe the project and its environmental impact, it
also identifies adverse environmental factors associated with the proposed
project. Its impact on the environment of the immediate surrounding area
will have the following features:
Earthworks: A basement is envisaged in the project design,
which shall involve removal of about 315,000 cubic feet of
earth during pitting;
Construction Impact: Construction impacts of the proposed
project could include noise, dust emissions, possible soil
contamination, solid and liquid waste from construction
activities, construction camp effluent, if any, vehicular traffic,
and smoke emissions and exhausts from vehicles, machinery
and equipment;
Wastewater Generation and Disposal: A large measure of
wastewater shall result from construction activities as also
during operation of the project;
Solid Waste: Solid waste shall be generated both during project
implementation and operation. Construction waste will include
removed vegetation, excess construction materials, construction
waste and excavated material. Inappropriate disposal, apart
from creating pollution of water and soil, also lowers general
aesthetic values of the local environment. Disposal of medical
waste during operation of the hospital shall be a primary
concern;
Hazardous Waste: Hazardous and medical waste shall be a
major cause for concern during project operation;
Socio-economic Impact: Construction of the hospital shall in
no way impact adversely on socio-economic conditions
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prevailing in the project area. Operation of the project shall not

have any adverse impact but shall rather enhance availability of
medical facilities in the project area;
Shadow: Shadows from structures, particularly in urban and
semi-urban areas, can have an adverse impact on the local
environment, resulting in loss of sunshine and thereby
impacting adversely on agricultural productivity and loss of
light and energy for structures upon which the shadow falls,
resulting in higher heating costs for affected households, and
Visual Intrusion Physical presence of tall buildings can have
some impact on aesthetics value of a project area by marring the
skyline and can also sometimes obstruct a scenic view.
Appropriate mitigation measures as explained in the environmental study
shall reduce, if not eliminate, the above impacts so that these are within
acceptable limits. The environmental study has established that operation
of the hospital will not impact adversely on socio-economic conditions
prevailing in the area and will in fact be beneficial in many respects, and
can be summarised as follows:
The two hundred bed modern surgical hospital shall add to the
existing pool of medical facilities in and around the area;
The proposed project shall cater especially for exclusive
medical facilities for workers and their families;
Equipment to be installed shall correspond to the latest
international quality control standards, thereby providing the
best medical attention in the project area;
The project cost of Rs. 2.7 billion during construction, and
annual operating costs of Rs. 75.76 million on establishment
and Rs. 160.35 million on operations and maintenance shall
lead to economic opportunities for local businesses;
The project under review will result in creation of at least two
hundred temporary and six hundred and five permanent
employment opportunities for skilled and unskilled workers,
and
Almost the entire unskilled labour force, and some skilled
workers, shall hail from the project area, thus benefitting the
local population directly.
The contents of Section 12 of the Pakistan Environmental Protection Act,
1997, whereby environmental approval has been made mandatory prior to
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commencement of a project that may have an adverse environmental

impact, make it plainly evident that any economic activity can have some
sort of environmental impact. Based on overall assessment of the
environmental impact of the proposed project, it is concluded that the
proposed project is not likely to cause any significant adverse impact on
the social, physical and biological environment of the area, provided that
suitable mitigation measures as identified in this study are implemented.
It is further concluded that all potential environmental concerns
associated with the project have been adequately addressed, and no
further study is required in this context. The objective of preparation of
an environmental study is to identify how environment is impacted and to
suggest mitigating measures to reduce if not totally eliminate adverse
effects of a project. It is accordingly recommended that environmental
approval for the proposed project, Surgical Hospital, Sukkur Bypass,
Sukkur, should be issued by Sindh Environmental Protection Agency,
subject to payment of the requisite scrutiny fee by the proponents of the
project.
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ENDNOTES
1
Page 11
www.langdonwilson.com
Page 16
www.environment.gov.pk.
Page 23
Supreme Court of Pakistan, (Shehla Zia and Others Versus Water and
Power Development Authority)
Page 23
www. environment.gov.pk/NEP/Policy.pdf)
Page 24
www.environment.gov.pk/Publications.htm
Page 25
www.environment.gov.pk/Publications.htm
Page 25
www.environment.gov.pk/act-rules/envprotact1997.pdf
Page 26
www.environment.gov.pk/act-rules/IEE-EIA-REG.pdf
Page 26
www.environment.gov.pk
Page 27
Page 28
Page 28
Page 28
Page 30
Page 30
www.environment.gov.pk/eia_pdf/D_rev_enReprt.pdf
Page 30
www.environment.gov.pk/eia_pdf/e_RevPublicCon.pdf
Page 30
www.environment.gov.pk/eia_pdf/f_Crit_%20Areas.pdf
Page 30
www.environment.gov.pk/eia_pdf/j_rev-Hous-guid.pdf
Page 31
www.equator-principles.com
Page 32
www.environment.gov.pk/act-rules/envprotact1997.pdf
Page 33
www.environment.gov.pk/eia_pdf/C_P_P11SeptRev.pdf
Page 37
Geo Project Consultants, Zain Plaza, G.T. Road, Zone-V, Islamabad,

Geotechnical Study, June 2011
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Page 45
Secretary, LESCO, circa 2005
Page 48
Director (South), Punjab Environmental Protection Agency, circa 2005
Page 49
John Briscoe and Usman Qamar, Pakistans Water Economy: Running

Dry, Oxford University Press, Karachi, 2006
Page 58
Ministry of Housing and Works, Government of Pakistan, Islamabad,

Building Code of Pakistan Seismic Provisions 2007
Page 58

Page 67
Ministry of Housing and Works, Government of Pakistan, Islamabad,

Building Code of Pakistan Seismic Provisions 2007
Page 69

Page 70

Page 72
Report of the National Water Quality Management Programme, Phase

II, Pakistan Council of Research in Water Resources, Ministry of
Science and Technology, Government of Pakistan, Islamabad
Page 73
Report of the National Water Quality Management Programme, Phase

II, Pakistan Council of Research in Water Resources, Ministry of
Science and Technology, Government of Pakistan, Islamabad
Page 73
Brief on Water Pollution, Pakistan Environmental Protection Agency,

Islamabad
Page 74
Fifth water Quality Monitoring Report 2005-06, Pakistan Council of

Research in Water Resources, Ministry of Science and Technology,
Government of Pakistan, Islamabad
Page 74
National Drinking Water Policy, Government of Pakistan.
Page 74
Page 74
Ambient Air Quality in Pakistan, Zulifkar H. Lodhi, Pakistan

Environmental Protection Agency, Islamabad
Page 75
Pakistan Clean Air Programme, Pakistan Environmental Protection

Agency, Islamabad
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Page 75
Air and Water Quality in Rawalpindi, Islamabad and Lahore, Pak-EPA

and JICA Study, Pakistan Environmental Protection Agency,
Islamabad
Page 75
Air and Water Quality in Rawalpindi, Islamabad and Lahore, Pak-EPA

and JICA Study, Pakistan Environmental Protection Agency,
Islamabad
Page 75
Air Pollution, Position Paper, Pakistan Environmental Protection

Agency, Islamabad
Page 90
Paul Wathern, Initial Environmental Examination: Theory and

Practice
Page 91
www.equator-principles.com
Page 112
Measurement of Noise Levels at Different Locations of Rawalpindi

and Islamabad, Pakistan Environmental Protection Agency, Islamabad
Page 121
Lighting Efficiency Improvements Programme, Phase 1: Commercial

Buildings, Enercon/UNDP/World Bank, 1994
Page 128
www.usgbc.org
Page 133
Waste Amount Survey in Islamabad, Pakistan Environmental

Protection Agency, Islamabad
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REFERENCES
Cunningham, William and Cunningham, Mary, Environmental Science: A Global
Concern
District Gazetteer, Sukkur, 1922
Eldorado County Air Pollution Control District, Guide to Air Quality Assessment:
Determining Significance of Air Quality impacts Under the California Environmental
Quality Act, First Edition, 2002
Government of Pakistan, National Drinking Water Policy
Government of Sindh, Development Statistics of Sindh, 2008
Hafiz-ur-Rehman and Fehmida, I., A Revised Checklist of the Reptiles of Pakistan,
Records of the Zoological Survey of Pakistan, Volume XIII
Lodhi, Zulifkar H., Pakistan Environmental Protection Agency, Government of
Pakistan, Islamabad, Ambient Air Quality in Pakistan
Ministry of Finance, Government of Pakistan, Islamabad, (1990-2010), Economic
Survey of Pakistan
Ministry of Housing and Works, Government of Pakistan, Islamabad, Building Code
of Pakistan, 1986
Ministry of Housing and Works, Government of Pakistan, Islamabad, Building Code
of Pakistan Seismic Provisions 2007 (draft)
National Geographic Website, Geology of Pakistan
Pakistan Council of Research in Water Resources, Government of Pakistan,
Islamabad, Report of the National Water Quality Management Programme, Phase I
Islamabad, Report of the National Water Quality Management Programme, Phase II
Islamabad, Report of the National Water Quality Management Programme, Phase III
Pakistan Environmental Protection Agency, Government of Pakistan, Islamabad, PakEPA and JICA Study, Air and Water Quality in Rawalpindi, Islamabad and Lahore
Pakistan Environmental Protection Agency, Government of Pakistan, Islamabad,
Position Paper, Air Pollution
168
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Brief on Water Pollution
Pakistan Environmental Protection Agency, Government of Pakistan, Islamabad and
the Japanese International Cooperation Agency, Guidelines for Solid Waste
Management
Measurement of Noise Levels at Different Locations of Rawalpindi and Islamabad
Pakistan Clean Air Programme
Waste Amount Survey in Islamabad
Population Census Organisation, Government of Pakistan, Islamabad, Population
Census, 1999
Pakistan Meteorological Department, Government of Pakistan, Islamabad, Published
Data
Quittmeyer, R.C., The Seismicity of Pakistan and Its Relation to Surface Faults in
Geodynamics of Pakistan, 1979
Reagan, J.A., and Grant, C.A., US Department of Transportation, Federal Highway
Administration, Highway Construction Noise: Measurement, Prediction and
Mitigation
Shamshad K.M., The Meteorology of Pakistan, 1988
Soil Survey of Pakistan, Government of Pakistan, Lahore, Notes of Land Use, Soils
and Landforms of District Sukkur
Soil Survey of Pakistan, Government of Pakistan, Lahore, Notes of Land Use, Soils
and Landforms of District Jacobabad
Wathern, Paul, Environmental Impact Assessment: Theory and Practice
169
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Environmental Impact Assessment: Surgical Hospital, Sukkur

APPROACH AND METHODOLOGY

Aims and Objectives of the Environmental Impact Assessment

Environmental Impact Assessment: Surgical Hospital, Sukkur

4.3.1 Pakistan Environmental Protection Act, 1997

International Law and Standards

DESCRIPTION OF THE PROJECT

Environmental Impact Assessment: Surgical Hospital, Sukkur

Size and Magnitude of the Operation

Operational Phase of the Project

Environmental Impact Assessment: Surgical Hospital, Sukkur

5.12.5 Chemical Contents

Soil Amplification Study

DESCRIPTION OF THE ENVIRONMENT

Geology and Geomorphology

Environmental Impact Assessment: Surgical Hospital, Sukkur

Quality of Life Values

ENVIRONMENTAL IMPACT ASSESSMENT

Impact Assessment Methodology

Definition of the Criteria for Determining Significance

Environmental Screening of the Proposed Project

Environmental Problems Related To Design

Environmental Impact Assessment: Surgical Hospital, Sukkur

Dewatering and Drainage

Health and Occupational Safety

SOLID WASTE MANAGEMENT PLAN

Environmental Impact Assessment: Surgical Hospital, Sukkur

TRAFFIC IMPACT ANALYSIS

Increases in Vehicular Traffic

SECURITY AND EVACUATION PLAN

Environmental Monitoring During Project Execution

SOCIAL IMPACT ASSESSMENT

13.1.1 Identification of Stakeholders

Social Impact Assessment and Survey

Social Survey Methodology

Measures for Surrounding Areas

COMPENSATION AND RESETTLEMENT

Environmental Impact Assessment: Surgical Hospital, Sukkur

Grievance Redressal Mechanism

APPENDICES (Volume II)

Environmental Impact Assessment: Surgical Hospital, Sukkur

This Environmental Impact Assessment has been prepared after consultation

Volume I of this report comprises a total of 169 numbered pages,

The Workers Welfare Fund (WWF), proponents of the project being

The reviewed project involves construction of a modern surgical hospital

PHYSICAL AND BIOLOGICAL ENVIRONMENTS

Environmental Impact Assessment: Surgical Hospital, Sukkur

distance of about two kilometres, while Daddo Canal is immediately to

Construction of the hospital next to the future site of Ghulam Mohammad

ENVIRONMENTAL IMPACT ASSESSMENT

An application along with this Environmental Impact Assessment is to be

Environmental Impact Assessment: Surgical Hospital, Sukkur

households presently residing at that site in quarters that were to

Environmental Impact Assessment: Surgical Hospital, Sukkur

shall become functional prior to project operation, is also

Environmental Impact Assessment: Surgical Hospital, Sukkur

environment, resulting in loss of sunshine and thereby

Despite environmental concerns indicated in the preceding section of this

Environmental Impact Assessment: Surgical Hospital, Sukkur

The project under review will result in creation of at least two

ENVIRONMENTAL AND SOCIAL COSTS

An assessment of the social impact is given in Chapter 13, which shows

COMPENSATION AND RESETTLEMENT