Questions/Answers

We take immense pride in explaining this wellbeing initiative that has benefitted nearly 82 thousand workers across 119 Ashghal projects Chronic diseases (diabetes- high blood sugar, hypertension – high blood pressure and dyslipidemia – high blood cholesterol) cause more detrimental effects than safety lapses at work places. Statistical evidence shows that medical near misses and health and wellness related events are significantly more than purely safety lapses. Taking this data into consideration, we at Ashghal decided that Health and wellness of every worker in the supply chain was equally important so we rolled out the health screening initiative for all workers. What action we took? With the support and involvement of Senior Management, the Health and Wellness Initiatives were launched in 2018 the biggest Ashghal projects which were called the Expressway Projects. Workers from over 60 countries are employed in various Ashghal projects, working for various contractors, supervision consultants and PMCs. Every month, apart from workers screening, we also conducted health audits of these project sites and also ensured individualised treatment plan for every worker identified with a chronic disease in all sites. The Health campaign targeted the Health of every single member of the supply chain. Starting from the grassroots level: 1. The contractor and subcontractor workforce 2. The supervision consultants 3. The Project management consultant workforce 4. The client ( Ashghal) workforce The true success of the campaign was linked to screening the bulk of the workforce which belonged to the contractors. We started from the bottom and went up the hierarchy. The stakeholders were sent a memo from the Directors Office and we started health screening by the site medical staff. Every work site has its own licensed medical team managing fitness to work procedure. Health screening of the workforce was conducted by these licensed medical professionals to detect chronic disease conditions.

These initiatives were targeted towards workers from 60 countries who are working in infrastructure projects in Qatar. Presently these workers receive excellent healthcare, chronic diseases screening and individualised follow up and medications completely free of cost. This has improved workers wellbeing and improved workers morale. This has helped Ashghal ( which is a public institution) to achieve our Sustainable Development Goals - health and wellness goals - This is linked to good health for all in our organisation. Ashghal values mentions that Health and Safety of our customers employees and contractors is our top priority.

This initiative supports Goal 3 - Good Health, Goal 8 - Decent Work and Economic Growth. By implementing these SDGs and Targets, we managed to improve the health and wellness of thousands of workers in 119 infrastructure projects benefitting nearly 82 thousand workers. This has benefitted people from 60 countries who are working in our projects, and has reinforced Ashghal's value that Health and Safety is our top priority. Out of the 82 thousand workers, nearly 6000 workers were not even aware they were suffering from chronic diseases and every one of these workers benefitted from the lab tests, specialist consultation and follow up - The best part was: We did this absolutely free for the workers Strict medical confidentiality was maintained And not a single worker was discriminated or removed from his job based on his medical tests.

A sustainable initiative is one which is popular and not very expensive. We utilized on team of 40 doctors and 123 nurses and used site based medical teams for the screening and referral to specialist consultation. The initiatives were met with rousing reception and workers were very happy that Ashghal was caring for their wellbeing. On top of this, all investigations, follow up and medicines were free which was supported by Ministry of Public Health. This made the initiative very sustainable and successful.

To start with there was no significant governmental shortfall at all. But we utilized the existing facilities and made things better. We had the huge workforce and the medical team, we conducted the tests and referred them for further specialist management. By doing this, we brought healthcare to the doorstep and worksite of thousands of workers. Even with the best healthcare systems in the world, the waiting time is a huge headache, we eliminated waiting time, we screened, analysed, counselled all at the workers worksite. We also arranged further consultations and follow up in hospitals using our priority booking. This eliminated any time delays and further streamlined the already robust governmental healthcare service in Qatar. Middle East is a region where thousands of immigrant workforce come, work and live. Ensuring their health and wellness and overall wellbeing is the key to ensuring lasting success of the projects. A healthy workforce means a success project. Qatar has a very well established health care system in place, Ashghal's Health and wellness initiatives, took this to a higher level.

Bulk of our workforce is single men. However our workforce also involves women in office based secretarial or managerial jobs. Our Health and Wellness Initiatives have benefitted men and women alike. These initiatives were offered absolutely free without any gender inequality.

The target groups were all low income workers who are essentially immigrant workers from 60 different nationalities. They are working and living in Qatar. The biggest benefit of " Ashghal Health and Wellness Initiatives" was that every workers, irrespective of his nationality, race, religion or ethnicity received the same health screening, follow up and free treatment. Whether it was a fasting sugar test or a consultation with a specialist endocrinologist or an MRI test, the workers benefitted from these initiatives and this made the target group healthier and happier. There were physical, mental and emotional benefits of our initiatives. Even in several developed countries there are institutional delays in medical appointments for tests like CT scan or MRI Scan. However in Ashghal Projects, we have ensured next day appointment - even for a simple GP consult or a specialist consultation involving radiology or blood tests.

With the support and involvement of Senior Management, the Health and Wellness Initiatives were launched in 119Ashghal projects. The Health campaign targeted the Health of every single member of the supply chain. Starting from the grassroots level: 1. The contractor and subcontractor workforce 2. The supervision consultants 3. The Project management consultant workforce 4. The client ( Ashghal) workforce The true success of the campaign was linked to screening the bulk of the workforce which belonged to the contractors. We started from the bottom and went up the hierarchy. The stakeholders were sent a memo from the Directors Office and we started health screening by the site medical staff. Every work site has its own licensed medical team managing fitness to work procedure. Health screening of the workforce was conducted by these licensed medical professionals to detect chronic disease conditions. Along with this mental health and wellness was also a key focus. The results were strictly confidential – only the worker, the site doctor and nurses and Ashghal Health Advisor Dr Surya had access to confidential medical information. Not merely stopping at screening the workers, nearly 6200 plus workers were detected with diabetes or hypertension or dyslipidemia) was given individualised treatment plan. Not one worker lost his/ her job. Workers were counselled with the results, the lab results were again validated by referral to a specialty hospital and individual treatment plan was started absolutely free of cost. This included diabetic medication – oral hypoglycemic, expensive insulin injections, expensive lipid lowering drugs or BP medications were all provided free of cost for the workers by ensuring a easy referral service between Ashghal and these referral hospitals. Every patient had an individual confidential medical file which was accessed only by the site doctor/ nurse and the referral doctor/ nurse and the regular monthly updates, lab results, medications and drug history, dosages, diet advice, next follow up dates, phone number of patient and phone number of doctors was documented for every single visit for workers identified with chronic disease.

The main obstacles were also our strength in a way. we had a diverse workforce with workers from over 60 countries. This caused initial concerns, the sheer size of thee workforce was a challenge, and maintaining uniformity in quality in all 11 projects was a challenge. We faced the challenges in a structured way. We organised a meeting of all sites doctors and nurses and gave them guidelines on testing, the fasting procedures, the testing process, the analysis of results, referral for further evaluation if any. We ensured open communication. This won the trust of all stakeholders and ensured success.

Ashghal's Health and wellness initiatives is innovative because, no other country in middle east or even in other parts of the world have initiated such a broad based health campaign targeting the entire workforce. Many good corporations do a one day health check up or a campaign. But we did not stop at a cosmetic one day campaign. This was an ongoing initiative, it still is. We did not just screen our workers, we identified high risk workers, we ensured strict medical confidentiality, we initiated free individualised follow up, treatment and rehabilitation and counselling ( wherever indicated).

We were inspired by our vision and values in ensuring a safe and healthy workforce. We are the host nation of FIFA 2022 World Cup. We drew inspiration from Qatar's National Vision 2030 and also drew inspiration from the fact we will be hosting thousands in 2022 for the world cup. We wanted to give back to these thousands of workers who are tirelessly working day and night in transforming Qatar into one of the best infrastructure hubs of the world. Our inspiration was to empower our workers with a healthy and happy life.

Every project site uses digital patient records. Every project submits digital ( monthly and quarterly) health reports which ensure safe, secure and swift communication and transmittal of health records within the medical team. Only non medical data was shared with non medical people. The confidential medical data was available only to doctors and nurses. The health initiatives embraced digital governance by making testing, information sharing, referrals everything online and digital.

No. This is implemented only within Ashghal projects. Initially were started only in few projects then we scaled it up in a few months. Presently 82 thousand workers are benefitting from these initiatives in 119 projects. British safety awards has appreciated our initiatives and out of more than 5000 entries, we were selected as the Best Wellbeing Initiative of the ear Award in 2020. The Ministry of Public Health in Qatar and Ministry of Labour have appreciated us and so did the International Labour Organisation. They have also recommended that such initiatives be implemented in other organisations in Qatar.

As mentioned above, there is a significant transferability potential throughout the world. It is proven medical fact that non accidental death rates ( caused due to chronic health conditions) are significantly higher ( in some countries nearly thrice) when compared to accidental deaths. All organisations around the world talk about safety but only very few talk about preventable health causes for safety lapses. A condition like Diabetes or High Blood pressure or High cholesterol has been shown through evidence based medicine to cause more deaths than falling from heights or working in an unsafe work environment. Every organisation should give importance to preventable health related conditions which will improve safety, contribute to worker's morale, enable to projects to be completed of time, safe money and improve the credibility of the employer. These tests are cheap and cost effective and have tremendous potential for transferability.

Human recourse - site based doctors, nurses, Admin staff, HR team and workers. Finacial recourses - site medical teams had their existing clinics that were fitted with testing equipment Referrral Centres - resources from Qatar Red Crescent and Ministry of Public Health.

In financial terms this is a very sustainable initiative. It doesn't cost much to screen workers. Out of the 82 thousand workers screened, nearly 6000 + workers were referred to Qatar Red Crescent Hospitals for free follow up and treatment. This was a free referral for all workers since the hospitals are free hospitals under the management of Ministry of Public Health Qatar. So there was no cost pinch. There is a robust referral system in place. Very good follow up plan available for each patient. So the initiatives are sustainable over time for financial and institutional reasons.

Oui

We conducted monthly heath audits as per ISO 45001 :2018 International Health and Safety Occupational Health and Safety Management System Standards. The monthly audits were conducted by supervision consultants who were external organisations employed by Ashghal to oversee the functioning of the contractors. Apart from the monthly audits, Ashghal Health Advisor Dr Surya also personally audited the projects every quarter.

A detailed audit template was used, which was common for all 119 projects. The contractors were assessed on evaluation of compliance, documentation and records, emergency response biomedical waste management and continuous improvement and overall hygiene and cleanliness. The teams were also audited for mental wellness screening and physical screening. This was linked to our departmental and corporate KPIs every quarter and this was reviewed for action items closure and follow up action by the top management of Ashghal.

The main findings showed nearly 7% of our workforce was suffering from one of the three chronic diseases - diabetes/ hypertension/ dyslipidemia. These high risk workers were given individualised treatment plans, regular follow up, the recourses were mobilized for this by the medical team - WITHOUT ANY EXPENSE - for the workers. The quality of the implementation was checked at various levels. Initially by the site medical team - doctors and nurses on a daily basis. Then by the supervision consultant by conducting a monthly audit. Followed by a quarterly health audit conducted by our Health Advisor at a corporate level. The main challenges faced - communication, language barrier, medical confidentiality, diverse multinational workforce, costs involved, logistics management o lab tests, counselling and follow up consultations were all sorted out and managed by effective medical team involvement and senior management support and clear operating procedures and professional efficient, timely workflow. Being cost effective and highly popular, the initiatives are here to stay. We have won a very prestigious international award from British Safety Awards this year - winning the " Health initiative of the Year Award" in 2020 among a very competitive field of more than 5000 entries is a testimony to our sustainability.

This Health Initiative would not have been possible without the help and support of governmental agencies in Qatar. The Ministry of Public Health helped us in the follow up of workers lab tests, the specialist appointments, fast tracking of blood tests, CT scans, MRI and all follow up, medications. This also involved rehabilitation, physiotherapy services and related allied health services. All this was made available free of cost to workers through Qatar Red Crescent and Ministry of Public Health in association with Ashghal's successful Health and wellness initiatives. When we look back, we are truly thankful to these agencies for making our initiatives successful and extremely popular amongst the workers. This institutional support was critical for our success.

The contractors in 119 projects, supervision consultants, PMCs, and the client Ashghal were all involved in this humongous exercise. Screening 82 thousand workers is no mean feat. This was achieved only due to stakeholder involvement at various levels. Right from the launch, to the implementation and follow up, all parties worked together happily and with a sense of team spirit. At every site, the site medical team was from the contractor - implementation The consultant oversaw the screening and ensured monthly checks and audits - evaluation Ashghal was the overall custodian and we managed the entire screening process on a daily, monthly and quarterly basis - conducting audits to ensure quality and efficiency of the process - implementation and evaluation. The smile on the face of the workers benefitted from these initiatives is the ultimate success of these multiple level stakeholder involvement.

The key lesson learnt was Health and wellness is much more closer than any other criteria for workers in any project. A healthy workforce is a happy workforce. A happy workforce works safely and delivers projects on time, thereby making it a financially viable project. We had several teething issues, like ensuring the same quality and process, training of manpower, timely reporting and meticulous follow up. Hospital appointments for follow up, transport, patient counselling were all areas where we finetuned our processes as we ran the programme. Today when we look back, it is much more robust and efficient. It is a process driver initiative and we have ticked all our KPIs. Our initiatives were initially launched in some of our projects, now they cover 119 projects. We have included mental wellness along with physical wellness as part of our wellbeing goals. Our plans to improve - to make this efficient and less time consuming. to include new comers who join existing projects. to continue ensuring strict medical confidentiality. We are also working on a live dashboard to reflect live medical stats, screening data and sharing non confidential medical stats like prevalence of a particular disease and follow up stats. This is a work in progress.