Gatineau – July 3rd, 2025 – Global Affairs Canada has determined that the proposed Rehabilitation of health facilities, including upgrades to water and sanitation systems, construction of incinerators, in South Yemen  is not likely to cause significant adverse environmental effects. 

This determination was based on a consideration of the following factors: 

• community knowledge; 

• comments received from the public; and 

• technically and economically feasible mitigation measures. 

Mitigation measures taken into account for this determination are:  

During the rehabilitation phase of 5 health facilities and the construction of the Medical Waste Zone: 

• Indoor air quality deterioration and injury to patients or healthcare workers are prevented by: Preventing access to areas under rehabilitation; Immediately removing construction waste; Limiting noise inside medical buildings; Using screens or nets to avoid flying debris and dust; and Completing construction work outside of the health facility normal working time.  

• Improper management construction waste will be prevented by: Undertaking waste segregation at source to separate hazardous from non-hazardous waste; Reusing and recycling waste when possible; Seeking guidance of local environmental officers to identify acceptable disposal sites; and ensuring that supervising engineers and health facilities managers will be responsible for ensuring that contractors do not illegally dump waste in non-designated areas.  

• Temporary disruption of healthcare services will be prevented by: Planning construction activities early to identify options to relocate patients or service areas with minimal inconvenience; and Completing construction work outside of the health facility normal working time. 

During the operation phase of 5 health facilities: 

• Health hazards and water sources contamination with solid waste will be prevented by: Ensuring proper waste segregation, handling, treatment, and disposal in healthcare facilities; Using reusable, recyclable, or biodegradable materials; Reducing packaging waste; Ensuring compliance with regulations; and Training workers and carrying out public awareness campaigns on the safe and environmentally responsible waste management. 

• Water contamination will be prevented by: Ensuring that soak pits are constructed more than 3 m above the groundwater table and at least 30 m away from the water sources; Monitoring the quality of drinking water regularly and desinfecting with chlorine in case of contamination; Ensuring that the health facilities infrastructures are in flood-proof and landslide-proof location; Educating the communities about the importance of water quality and the risks of water pollution. 

• Water scarcity will be prevented by: Assessing the recharge capacity of water sources to avoid potential depletion; Promoting water conservation practices, encouraging rainwater harvesting, and sustainable agricultural practices. 

During the Planning and Design phase of the Medical Waste Zone component of the initiative: 

• Exposure of public and healthcare staff to gas emissions arising from the incinerator site beside health-care buildings will be prevented by: Assessing normal wind patterns to properly position the incinerators and extend the incinerator chimney above the health facility level; Using proper bricks in the incinerator to maintain temperatures above 850°C (or higher for hazardous waste) to ensure complete combustion and minimize toxic byproducts 

• Improper waste management will be prevented by the formulation of a Waste Reduction and Segregation Plan to outline best practices to minimize the amount of waste requiring incineration. This Plan will include an assessment of waste generation, measures to minimize waste (recycling, reuse, etc.), guidance on segregation and storage, information on waste collection destinations, and comparison of treatment and disposal options both onsite and offsite, training courses, and procedures for monitoring waste management. 

• Undesired air emissions due to incomplete combustion will be prevented by ensuring that the incinerator has a well-engineered design, considering factors including: the incinerator will reach temperatures of 850°C or greater in the primary chamber and 1100°C or greater in the secondary chamber, with a residence time of at least two seconds in the secondary chamber; the waste will have a heating value above 2000 kcal/kg, a content of combustible matter above 60%, non-combustible solids below 5%, non-combustible fines below 20%, and a moisture content below 30%), the types of waste accepted will be limited to exclude items that may cause problems; and the design will include detailed engineering plans and appropriate materials to reduce the risk of premature failure.  

• Incinerator emissions will comply with national standards and the Stockholm Convention's guidelines on best available techniques and best environmental practices.

• To prevent the misuse of the incinerator, IMC will develop an Operation manual with clear instructions to achieve the desired combustion conditions and minimize emissions. IMC will also properly train and manage incinerator operators. 

• To prevent environmental and health risks related to the generation and management of ash, training on safe disposal will be ensured. Ash will be disposed of in sites designed for hazardous wastes and fly ash will be treated as hazardous waste and sent to a specialized waste-disposal facility or treated onsite. Bottom ash will be disposed of in landfills specifically designed for hazardous substances. 

Durint the Operation phase of the Medical Waste Zone component of the initiative: 

• Air pollution from onsite incinerator will be prevented by: Adopting the recommended stack design; Ensuring that the operator of incineration unit is adequately trained; and Involving the health facility manager in the choice of location of incinerator at each site.  

• Community health risk due to improper waste management will be prevented by: Ensuring proper waste management practices of health facilities according to the waste management guide provided by IMC; Undertaking annual environmental audit of entire healthcare facility including waste management practices; Ensuring regular monitoring of solid, liquid waste management practices and incineration; and Ensuring proper management of pharmaceutical waste by hiring a consultant to develop measures and guidelines in accordance with the national healthcare waste management plan.  

• Occupational health and safety risks will be prevented with proactive measures in response to the identified risks. For unavoidable risks, personal protective equipment will be provided to workers  

• Misuse will be prevented by providing training on operation and maintenance, offering regular supervision, and ensuring that only trained authorized personnel operate the equipment.  

• Hazard risks on water resources, soil and ecosystem will be prevented by providing training on safe disposal of incinerators residuals, such as ash.   

Global Affairs Canada is satisfied that that the carrying out of the project is not likely to cause significant adverse environmental effects. 

Therefore, the International Medical Corps (IMC) may carry out the project, exercise any power, perform any duty or function, or provide financial assistance to enable the project to be carried out in whole or in part.