Development of an Integrated Community Health Program for a Large Oil and Gas Project
Authors: Nowosiwsky Andry , Moore John D. , Hancock David , Balge Marci Z. , Krieger Gary R. 
Published: March 2016

Abstract

OBJECTIVE
Onshore oil and gas projects can have large footprints with potentially significant impacts on local communities over its producing life. In complex developing world country contexts, project execution challenges are often exacerbated by a high background burden of disease and a fragile local health system. The ExxonMobil-constructed and operated Papua New Guinea (PNG) LNG Project (Project), the largest private investment in the history of Papua New Guinea, is an example of a large development in a significantly challenged community health context. Having recognized the health-related risks early, the Project team developed an integrated community health impact mitigation and investment plan consisting of: (i) the development of a private-public partnership with the PNG Institute of Medical Research (PNGIMR) to execute a robust longitudinal surveillance system, (ii) capacity building efforts to strengthen both local and national health care and diagnostic capacity, including (a) a state of the art infectious disease research laboratory managed by PNGIMR and located at the PNG School of Medicine campus and (b) a teaching and clinical support by both PNGIMR and seconded faculty from Texas Children's Hospital and (iii) strategic impact prevention measures, e.g., water/sanitation, domestic violence, health lifestyles, executed by local NGOs across all project areas.

METHODS
Based on the findings of a pre-project health impact assessment, the Project assessed that a comprehensive integrated impact mitigation and focused capacity building program for potentially impacted communities was essential. Because of the complexity and geographical distribution of the project, control/comparison sites were also developed so that any significant changes in community health outcomes could be placed in context. Health stakeholders included the Project workforce, affected communities and both provincial and national health authorities. Interventions followed best practice in building public-private partnerships and were fit to purpose, i.e., tailored to address local and provincial / national issues that would be directly impacted by the PNG LNG Project.

RESULTS
Formal Memorandum of Understanding and Investment Agreements between ExxonMobil PNG Ltd and PNG health authorities were executed. Longitudinal surveillance included two project impact sites and two comparison sites covering over 50,000 persons. The entire surveillance system was accepted into the INDEPTH Network and is fully compliant with international health monitoring standards. The PNG LNG Project was the first oil and gas sponsored project in the 45-member, 20-country, 50+site INDEPTH Network. A variety of population demographic and specialty studies have been executed that have accurately tracked changes in socio-economics and in/out migration while determining prevalence and incidence for major diseases such as tuberculosis and sexually transmitted infections, including the first ever study of HPV in PNG women.

NOVEL/ADDITIONAL INFORMATION
Key findings are presented. The development of an integrated, comprehensive community health program including internationally recognized longitudinal monitoring structure represents a new benchmark both for PNG and the oil and gas industry. As noted through multiple engagements with the PNG government and donor community such an approach can be replicated by others in the extractives as well as non-extractives industries using field proven methods pioneered on the PNG LNG Project. In so doing the improvement in coverage and data quality can assist in improving public health policy development and implementation.