Health Management Preparation for Project Activities
Health Management Program
1. General Health Strategy
- Develop strategy for identification
and management of workplace
health hazards.
- Learning from Phase 1 on
Clinic/medical facilities design and
capacity
2. Health Contract and
Procurement Strategy
3. Emergency Response
- Strategy to handle emergency
cases
- Train project team and engineering
contractors on injury & illness
reporting.
- Ensure worker on the spill, gas
release protection and monitoring
programs are in place.
Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk
Objective
Contractor and Project Health
Management Strategy
Ensure adequate medical facilities are
available at each work site.
Clearly Scope of work and Requirment
Emergency preparedness and readiness
Health reporting and recording
Health prevention programs
Health Aspect
All health risk in the workplace
Illness cause of general diseases, accident
and work related diseases
Competency and Capability Health resources
and Medical facilities needed
Life treathening cases cause of general
diseases, accident and work related diseases
Life treathening cases cause of general
diseases, accident and work related diseases
Hazardous exposure
Management Risk
1. Health Risk Identification and
Assessment
2. Decide Health Management
strategy related to HIRA
Provide Medical facilities related to
the risk and emergency
preparedness
1. Build details of health
requirements into contractor pre-
qualification, evaluation, engineering
& contractor terms and conditions
2. Third parties services providers to
support project and contractors
activities abroad.
Contractor and Project team Medivac
& incident response preparedness
Contractors through Medical provider
has to have reporting and recording
systems
Prevention programs (IH aspect) to
prevent Hazardous exposure through
IH monitoring
Administration control and provide
appropriate PPE
 Health Management Program
4. Health Resource
Competency and Capability
5. Health Impact Assessment
HIA, since the project is in the
current operation project vicinity, the
impact may be due to the increase
of persons on site. This impact has
been also covered in the current HIA
when was in construction project,
however PEH will create
documented evaluation.
6. Health Risk Assessment
HIRA, the contractor should develop
an HIRA plan and get approval from
Oil & Gas Company IH in performing
a HIRA, develop a risk register and
establish adequate agreed control
measure and remedial actions. This
should include but not limited to:
Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk
Objective
Clear Scope of Work and Requirment
for All Health Services
Health procedure related to Health
Programs
Present Health Status of Community
Health Services available
Possible impact on Health of host
community?
Develop mitigation measures in
consultation with local communities
Physical Aspect
Chemical Aspect
Health Aspect Management Risk
Competency and Capability Health resources - Select a medical contractor to
and Medical facilities needed provide medical personnel including
industrial hygienist and medical
equipment.
Assurance in integration between Health - This medical service contractor
Operation and Project should be under coordination of
current Tangguh Medical Service, to
ensure an integrated Medical
Emergency Response Plan.
Contagious diseases Health Screening: Malaria, Diarrhea,
etc
is not meet the requirment related to the risk Support with appropriate medical
service needed, Community health
programs
Contagious diseases Get Community health data, Health
Screening: Malaria, Diarrhea, etc
Contagious diseases Analyze Health data from community
and do mitigation programs to
prevent contagious diseases in
project site
Temperature & Humidity - Health provider has to have HIRA
Noise data and have action plan to control
Vibration and manage Health aspect in all
project activities
Electromagnetic / non ionization radiation
- Health provider has to have develop
Ionizing Radiation Health promotion and Health
Prevention programs
Dust
Fume
 Health Management Program Objective Health Aspect Management Risk
Mist
Vapor
Gas
Smoke

Other Chemicals Carcinogens

Sensitizers

Biological Virus
Bacteria
Fungus
Malaria (Protozoa)
Worms
etc

Psychosocial Stress
Fatigue

Ergonomic aspect Manual Handling

Repetitive Work
DSE
Shift work
Illumination
Other ergonomics
Air travel
Water Safety
Working at Height
Confine space
Driving
Welfare

7. Fitness for Task Requirements-

all staff and Health Surveillance

Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk

 Health Management Program Objective Health Aspect Management Risk
Work involving:
Fit for task requirment for each task / Psychological examination /
Psychologically demanding
hazardous exposure identified Questioner
Related to physical examination &
Working at height
questioner
Related to physical examination &
Offshore work
questioner
Examination of Cardiovascular,
Temperature extremes
Nephrology, Skin, Liver function
Physical examination related to
extremities, join, shoulder, limb and
Manual Handling
back, reflex + Questioner for manual
handling
Physical examination and Specific
Confined space entry
Questioner for Confined space entry
Specific examination for Driver,
Driving especially Vision Field, distance
vision and deep perception
Physical examination and Specific
DSE user
Questioner for DSE
Physical examination (especially
SCBA (self contained breathing
related to Respiratory organ) and
apparatus)
Specific Questioner for SCBA
General Examination + Specific
Safety critical work (if available)
job/task
Specific examination and questioner
Food handler (especially related to transmission
infection prevention)
Specific examination related to the
Emergency response risk, ERT questioner and SCBA
questioner
General examination & Fatigue
Shift work
questioner

Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk

 Health Management Program Objective
Biology hazards (misal: bacteria /
parasite)
Physical hazards (misal: bising / radiasi)
Specific hazards (misal: listrik / ledakan)
Chemical hazards (misal: irritant /
carcinogen)
8. Human Factor
Human factor identified
Feed into safety case
7. Medical Services Required
Local facilities in existence?
Purpose built medical room necessary:
Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk
Health Aspect
Biological (e.g. bacteria / parasite)
Physical (e.g. noise / radiation)
Special Hazards (e.g. electric / explosives)
e.g.. Chromium, Cd, Pb, Hg & asbestos
How the human factor can be seen in all
project activities that can be impacted to
Health
Accident / Ilness anticipation
Management Risk
Specific examination: Malaria,
Hepatitis, etc
Specific examination: Audiometry,
Complete blood (Radiation),
ECG/Liver & Renal function (Heat),
Spirometry/Chest Xray (Dust)
Specific examination: Complete
blood, ECG,
Specific examination: Complete
blood, Biological monitoring
Contractor should develop a HF
integration plan.
Maintain HF integration plan & HF
issues register
Utilize HF champion (SPC) & identify
any additional resources required.
Consider choice of process, allocate
functions to people/system, critical
task analysis, assessment of
workload etc.
Develop HF style guides & HF
specifications.
Make the procedure related to
safety/Health cases to get lesson
learn (Investigation procedure)
- Fixed?
 Health Management Program Objective Health Aspect Management Risk
- Transportable?
Local professional acceptable?
Imported staff needed?
Medical Supplies Medical equipment
Identify safe source
Medicine
as reference using Tangguh
Medical evacuation plan Medevac & Mass Casualty
Procedure
Insurance Local
Expatriate
Develop relation with Medical Care
locally and develop link with Oil & Gas
Company occupational health and
Medical services.
Through Medical provider to dispose
Waste disposal
Medical waste or PPLI

9. Workplace design Ergonomics Office and the workplace

Accommodation
Catering
Medical room

Comply with Local government

10. Kitchen Check
regulation & best practice
Are product at risk from pests and/ or
chemicals?
Are suppliers reputable and hygienic?
Is the shelf life of stock being adhered
to?
Are stock temperatures satisfactory?
Are raw and cooked foods separate? To
avoid cross contamination?
Is packaging of food clean and
adequate?
Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk
 Health Management Program Objective Health Aspect Management Risk
Are there potential foreign bodies in the
preparation area?
Are suitable pest control measures in
place?
Are chilling and cooling procedures in
place?
Is personal hygiene satisfactory?
Are surfaces, utensils & equipment
clean?
Is anyone responsible for monitoring
cleaning?
Is cleaning adequate?
Are staff washing their hands routinely?
Are there adequate hand drying
arrangements and wash basin facilities?
Do staff knows that they should report
certain types of illness and infection?
Are there procedures in place for
reporting such illnesses/ infections?
Is food waste and refuse being stored
and collected hygienically?

11. Hotel Check / Camp

General Appearance
Cleanliness
Smell
Bathroom Water
Avaibility
Color
Temperature
Potable?
Kitchen (see specific checklist)
Bedroom Ventilation

Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk

 Health Management Program Objective Health Aspect Management Risk
Lighting
Power points
Insect
Mini bar
Bedding
Room layout
Enables desk work?
Computer work
Leisure centre Sport facilities, rest area, etc

Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk

Referensi Jumlah Tenaga Medis yang dibutuhkan sesuai dengan Jumlah Pekerja,
Faktor Risiko, Transportasi & Waktu yang diperlukan untuk Rujukan, sebagai
berikut:
1. Peraturan Pemerintah:
i. Sesuai dengan PERMENAKERTRANS RI No. 03/MEN/1982, maka pengadaan
Pelayanan Kesehatan diadakan tergantung pada jumlah tenaga kerja & tingkat
bahayanya, sbb:
a) Tenaga kerja lebih dari 500 orang, harus mempunyai klinik dan dokter yang praktek
setiap hari, dan bila mempunyai 3 shift , klinik melayani dalam setiap shift.
b) Tenaga kerja 200 - 500, tingkat bahaya rendah, harus mempunyai klinik, buka tiap
hari - dilayani oleh paramedis, dan dokter praktek 2 hari sekali (3 kali seminggu).
c) Dengan tingkat bahaya tinggi, pelayanan kesehatan seperti butir 1.
d) Tenaga kerja 100 - 200, tingkat bahaya rendah, harus mempunyai klinik, buka tiap
hari - dilayani oleh paramedis, dan dokter praktek 3 hari sekali (2 kali seminggu).
Dokter yang memimpin & menjalankan Pelayanan Kesehatan harus mendapat
persetujuan dari Kantor DEPNAKER wilayah, bersamaan dengan izin pembentukan
Pelayanan Kesehatan.
ii. Sesuai dengan Surat Edaran Departemen Pertambangan dan Energi RI, Direktorat
Jenderal Minyak dan Gas, nomor 1123 / DMT / Migas / 1982 yang menyatakan bahwa
untuk kegiatan pengeboran harus menyediakan tenaga Dokter.

2. Praktek terbaik dari beberapa perusahaan Oil & Gas:

Keperluan tenaga medis untuk beberapa proses kerja di perusahaan Oil & Gas sebagai
berikut:
Matrik keperluan Tenaga medis di Oil & Gas:
Operasi di Darat

Activitas Skor
Seismic 1
Operations 2
Construction 3
Demobilization 3
Drilling 4
Jumlah Personal Skor
< 20 1
20-99 2
100-499 3
500-1999 4
2000-4000 5
Waktu yang dibutuhkan untuk Rujukan ke Rumah Sakit Skor
< 30 menit 1
< 60 menit 2
1 - 6 jam 3
> 6 jam 4
Tambahkan masing-masing katagori skor diatas dan
lihat Total Skor
Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk
 Total
Tenaga Medis yang direkomendasikan**
Skor
Anggota P3K terlatih (EMT = Emergency Medical
3
Technicians)
Perawat (Paramedic) + EMT 4-5
Dokter + EMT/Paramedic 6-8
Dokter + 1 atau 2 tenaga medis lainnya 9-10
Dokter + 2 atau 3 tenaga medis lainnya 11-12
Dokter (2) + 3 atau 4 tenaga medis lainnya 11-13

Operasi di Lepas Pantai atau Daerah Terpencil

Activitas Skor
Seismic 1
Operations 2
Construction 3
Demobilization 3
Drilling 4

Jumlah Personal Skor

< 10 1
11-20 2
> 20 3

Waktu yang dibutuhkan untuk Rujukan ke Rumah Sakit Skor

< 30 menit 1
< 60 menit 2
1 - 6 jam 3
> 6 jam 4

Tambahkan masing-masing katagori skor diatas dan lihat

Total Skor
Total
Tenaga Medis yang direkomendasikan**
Skor
Anggota P3K terlatih (EMT) 3
Perawat (Paramedic) + EMT 4-9
Dokter + EMT/Paramedic 10-11

*Fasilitas kesehatan spesialis khusus yang mempunyai tenaga medis spesialis ahli dan
fasilitas medis pendukung dan pengobatannya.
**Tenaga medis yang tersedia seharusnya yang dapat menangani skenario kasus terburuk
dalam waktu 2 jam (kasus Jantung) dan 6 jam (kasus Luka Bakar).

Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk

 Waktu yang diperlukan untuk merespon Kondisi Darurat Medis
Perusahaan harus mempertimbangkan waktu respon yang mengikuti terjadinya kasus
darurat medis yang disesuaikan dengan kondisi local dan fasilitas yang tersedia.
Salah satu referensi yang bisa dijadikan pertimbangan adalah panduan dari IPIECA – OGP
2011(5):

Response time Responder Site of health care

< 4 minutes Level 1 health-care provider
< 20 minutes Level 2 health-care provider or
Level 3 health-care professional
< 1 hour Level 4 health-care professional
< 6 hours Level 5 health-care professional
Site of the incident
Site of the incident (Level 2) or
field first-aid station (Level 3)
Designated primary health-care
unit
Secondary and tertiary health-care
unit

Dari tabel diatas dapat dijelaskan sebagai berikut:

 Selama waktu kurang 4 menit – akan ditolong oleh first aider, jika dibutuhkan
pertolongan lebih lanjut maka akan dilakukan akan dilanjutkan penangannanya:
 Dalam kurang waktu 20 menit – akan di tangani oleh perawat atau dokter dari lokasi
yang area khusus (first aid station)
 Dalam waktu kurang 60 menit – pasien akan ditangani untuk stabilisasi di fasilitas yang
mempunyai paramedis/perawat, dokter umum atau dokter emergency untuk melakukan
pengobatan.
 Selama waktu kurang 6 jam – pasien akan dirujuk ke rumah sakit yang mempunyai
fasilitas lengkap (tertiary referral centre).
Referensi lain dari Perusahaan Oil & Gas:
Waktu respon mempertimbangkan persyaratan penanganan darurat medis sesuai dengan
waktu yang dibutuhkan yaitu:
 Selama waktu kurang 4 menit – akan ditolong oleh first aider, jika dibutuhkan
pertolongan lebih lanjut maka akan dilakukan akan dilanjutkan penangannanya:
 Dalam kurang waktu 10 menit – akan di tangani oleh perawat (emergency medical
technician or paramedic with the patient).
 Dalam waktu kurang 60 menit – pasien akan ditangani untuk stabilisasi di fasilitas yang
mempunyai paramedis/perawat, dokter umu atau dokter emergency untuk melakukan
pengobatan.
 Selama waktu kurang 6 jam – pasien akan dirujuk ke rumah sakit yang mempunyai
fasilitas lengkap (tertiary referral centre) yang dapat menangani kasus darurat medis
seperti: kasus darurat penyakit jantung, luka bakar dan kasus darurat trauma lainnya.
Dengan semakin jauhnya dan atau lamanya mendapatkan pelayanan kesehatan yang
dibutuhkan untuk penanganan keadaan darurat medis untuk kasus tertentu, akan
berpengaruh kepada hasil dari penanganan kedaruratan medis tersebut.

Disiapkan oleh: dr. Kasyunnil Kamal, MS., SpOk