Document of The World Bank FOR OFMCL VSE ONLY Repot No. P-6064-YEK HEMRANDUM AND RECOMMENDATION OF THE PRESIDENT OF THE INTERNATIONAL DEVELOPMENT ASSOCIATION TO THE EXECUTIVE DIRECTORS ON A PROPOSED CREDIT OF SDR 18.8 MILLION TO THE REPUBLIC OF YEMEN FOR A FAMILY BEALTH PROJECT June 4, 1993 MICROFICHE COPY Report No.sP- 6064 YEM Type: (PM) Title: FAMILY HEALTH PROJECT Author: DE GUZMAN, A. Ext. :32527 Room:H 9093 Dept. sMN2PH h docunent bh a restied ditibti a mey be used by recpiets only to the performe of ther offial duftes Its contents may not otherwise be dicosd without World Bank satborzatloL C YM EQUIVYA IS US$1.00 - Yemeni Rial (YR) 12.00 YR 1.00 - US$0.08 ABBREVIATIONS FP Family Planning ICB International Competitive Bidding IDA International Development Agency LCB Local Competitive Bidding MCH Maternal and Child Health MOPD Ministry of Planning and Development MOPH Ministry of Public Health _CC Project Coordinating Committee FHC Primary Health Care PIU Project Implementation Unit P1O Project Management Office UNFPA United Nations Fund for Population Activities UNICEF United Nati=ns Children's Fund WHO World Health Organization GOVERNMENT OF THE REPUBLIC OF YEMEN !ISCLX January 1-December 31 FOrt OmCIL USV ONLY REPUBLIC OF YEMEN FANILY HEALTH PROJECT CREDIT AND PROJECT S"MMARY Brrover: Government of the Republic of Yemen BeneficiaKy: Ministry of Public Iealth Amount: SDR 18.8 million (US$26.6 million equivalent) Terms: Standard IDA, 40 Years Maturity Financing Plan: IDA US$26.6 million Government U 3.6 million Total USS30.2 million Economic Rate of Return: Not Applicable Staff ADDraisal Report: No. 11900-YEM dated June 4, 1993 an: IBRD 24849 I This document has a restricted distribution and may be used by recipients ony in the performane of their official duties. Its contents may not otherwise be discosed without Wodd Bank authoriation. EIXiSYJ ANDS AKQ%RMWEDAIO OF THE PRID=EN OF THE INTERNATIONAL DEVELOPMENT ASSOCIATION TO THE ECUTIVE DIRECTORS ON A PROPOSED CREDIT TQ THE REPUBLIC OF YEMEN FOR A FA4ILY HEALTH PRWJECT 1. I submit for your approval the following memorandum and recommendation on a proposed credit to the Republic of Yemen for SDR 18.8 million (US$26.6 million equivalent) to help finance a project for family health. The credit would be extended at standard IDA terms with a maturity of 40 years. 2. Backgrgun. Yemen's health status indicators depict serious problems. The current population is 13.1 million (1992), with the growth rAte a high 3.6 percent; life expectancy at 48 years is 14 years less than the average for low-income countries, 30 years less than that for industrialized countries; maternal mortality, at 1,000 deaths per 100,000 births, is 100 times that of industrialized countries; infant mortality, at 124 per 1,000 live births, is a reflection of the factors affecting maternal mortality cnd is also very high compared to other countries of similar socio-economic development. The incidence of endemic diseases is high, reflecting the lack of preventive health services, including effective health education programs, unsafe drinking water, and poor sanitation facilities. 3. The Ministry of Public Health (MbOPH) is responsible for managing the health care system. Health services in major urban centers, where about 22 percent of the population lives, are provided by specialized civilian and military hospitals (for tertiary care) and by a thriving private medical practice. Provision of health services outside of the major urban centers rests with the primary health care (PHC) system of 949 health units in villages, supported by 345 health centers in larger towns; 60 district hospitals, the point of referral for the primary health care network, provide secondary care. The country is divided into 245 districts which cover large geographic areas; 35 percent of the districts have a catcbment population of over 50,000 people. 4. Government policies give highest priority to improving the quality and quantity of basic curative services and preventive activities, and particular attention is being given to the most vulnerable groups of the population: women of reproductive age and children. Implementation of these policies is, however, hampered by serious constraints. Sector administration is highly centralized in Sansa and Aden and weak at governorate and district levels. Financial resources from the government budget are largely inadequate, and much improvement is needed in the coordination of donor assistance. Health care delivery is unsatisfactory, in terms of both the quality of services and their coverage. Poor quality of services is due to various weaknesses ranging from the lack of qualified staff and the shortage of essential drugs to the poor condition of the physical infrastructure. The result is inappropriate utilization of the health care delivery system, as patients tend to bypass lower-level facilities, which are generally poorly equipped and staffed, in favor of hospitals. As for coverage, physical accessibility, only 45 percent of the population is served by the existing health care delivery system. 5. Although the government objective to achieve greater coverage of the health care delivery system is fully justified in the long-term, improved quality of existing services deserves higher priority in the short-term. At the same time, however, innovative, cost-effective approaches to service delivery need to be developed to reach the large number of small, isolated communities scattered throughout the country. 6. Rationale for IDA Involvement. The previous IDA projects aimed at developing management and training capacity while establishing the basic infrastructure for health care delivery. The proposed project represents continuity with those aims by specifically focusing, on improving three key areas: health staff training and development, health education, and management of medicul supplies. These areas are directly relevant to the needs of the population groups at highest risk, particularly among the rural poor. As to health infrastructure. tais project represents a departure from the previous ones because it would focus on improving existing facilities, rather than constructing new ones, and on upgrading the quality of health services, especially for women and children, offered at those .acilities. In addition, the project would initiate limited pilot activities to examine appropriate ways to improve the coverage of services for remote rural communities. Assistance to expand the health care delivery system would be considered under subsequent projects, conditional to improved quality of current services and based on the lessons learned through the development of outreach services to be supported by this project. 7. The proposed project would address key weaknesses that affect sector performance nation-wide while improving quality of service delivtery in selected rural districts. As an initial step toward improving coverage, pilot activities would be undertaken in two districts to examine ways to provide PHC to remote rural communities. The project also presents opportunities for strengthening donor coordination in the sector. In primary health care services, the proposed project would complement other-donor assistance by selecting only those areas (health districts) with no significant support from any other donor. In health education, the project would complement the efforts of other donors by targeting assistance in areas not sufficiently covered, i.e., messages on maternal health and in women's participation in the health sector. And in the pharmaceutical subsector, the project would, in concert with bilate;.ll and other international donors, support the development of a single national drug procurement and distribution system. IDA presence in the sector and continuing dialogue with the Government are significant considerations in some donors' decision to continue with their own assistance programs. 8. Project Obieetives. The proposed project would assist the HOPH in contributing to the implementation of the national population policy, articulated in 1991, to reduce fertility and maternal and infant mortality. The objectives of the proposed project are: (i) to improve the access to, and quality of, maternal-child health and family planning (NCH/FP) services within the PHC system; and (i1) to improve management effectiveness in the health sector more broadly. 9. Project DeserLition, The projeet includes three interrelated components: (i) strengthening the delivery of NCH/FP services in seven - 3 - districts in rural areas through the rehabilitation of district hospitals, health centers, and health units, establishment of referral and supervision systems, and conducting pilot activities; (ii) enhancement of training and health education programs sector-wide by increasing the capacity of existing health training institutes, curriculum improvement, strengthening training supervision, and supporting the Government's program for the delivery of media-bornm messages ln maternal health, family planning and the role of women in the health sector and the delivery of health education messages through interpersonal means; and (iii) improvement of sector management through the development of a health information system, strengthening the research capacity of the OPH, strengthening the pharmaceutical logistics system, and strengthening the maintenance and procurement capacity of the MOPH. 10. Proleet Coat and Financing. The total project cost is estimated at US$30.2 million equivalent, of which US$22.2 million equivalent (73 percent of the project cost) is the foreign exchange component. The proposed IDA credit of SDR 18.8 million (US$26.6 million equivalent) will finance about 90 percent of the total project cost excluding taxes and duties. The Government will finance US$3.2 million equivalent. Project costs and financing plan are presented in Schedule A. The amounts and methods of procurement and disbursement, and the disbursement schedule are shown in Schedule B. The timetable of key processing events is in Schedule C, and the status of Bank Group operations in Yemen is in Schedule D. A map of Yemen is also attached. The Staff Appraisal Report. (Report No. 11900-YEM) for the project is being circulated separately. 11. Project Implementation. The project would be implemented by the OPH over a period of six years and disbursed over the period 1994-2000. Project implementation would be overseen by a Project Coordinating Committee (PCC) c-haired by the Vice Minister and composed of key MOPH officials, each responsible for a major project activity, and a representative from the Ministry of Planning and Development (NOPD). The PCC would be assisted in overall project coordination by the existing Project Management Office (PMO) which would serve as secretariat to the PCC. The PMO would monitor project performance, accounts, expenditures, costs, and compliance with IDA Guidelines; consolidate progress reports; and serve as the NOPH contact agency with IDA. Implementation of project components would be the responsibility of existing OPH line departments at the central level, strengthened with the appropriate technical assistance services where necessary; in the project areas, implementation would be the responsibility of training-supervision and district management teams. 12. Project SustainabiLity. The OPH has played an integral role in the analysis and development of the project, and project ownership by those responsible for implementation is high. Further, the project components would be implemented by regular units of the 1OPH, ensuring operational continuity and institutional memory. Project districts have been selected on the basis of accessibility, population catchment area, existence of facilities, and availability of staff--factors that contribute to the maintenance of sustained operations. In addition, to the extent possible, the district management teams would be recruited from regular NOPH staff at local levels. While incremental recurrent costs are deemed sustainable, Government investments are -4- needed to maintain an acceptable supply of essential drugs in public health facilities in the field. 13. Lessons Learned from Previous IDA I2volvement. Of the four projects in the health sector since 1982, two (amounting to US$18.7 million in IDA credits) have been completed, the two others (amounting to US$19.5 million in IDA credits) are ongoing.. For the northern governorates, the First Health Project (Credit 1294-YAR), completed in 1989, financed the construction of essential infrastructure and the training of central MOPH management staff; the ongoing Health Sector Development Project (Credit 2151-YEN) is financing the construction of training institutes, drug warehouses in selected governorates, and medical equipment maintenance workshops. For the southern governorates, the Health Development Project (Credit 1377-YDR), successfully completed in 1989, established PHC facilities in Abyan, Lshej, and Hadramout; the ongoing Second Health Development Project (Credit 1972-YEN) is constructing PHC facilities in Aden, Shabwa, and Mahra. 14. The principal lesson learned from the First Health Project was that creating a Project Implementation Unit (PIU) outside of the mainstream MOPH management structure isolates the PIU and project activities. In the proposed project, NOPH management has been involved in all phases of project development (fostering ownership of the project), and regular NOPH management will constitute project management. The principal lessons learned. from the Health Development Project were that project design should be simple, and having many cofinaciers complicates implementation of this type of project. The design of the proposed project is for IDA financing alone, without cofinaciers, but the proposed project has developed a simple methodology for selecting health districts in order of priority, that could be adopted by other donor agencies wishing to assist the sector on the basis of objectives similar to those of the project. Moreover, project component activities are coordinated with other-donor assistance, e.g., WHO and other bilateral programs in pharmaceuticals, and UNICEF and UNFPA programs in health education. 15. Agreements Reached. Agreement has been reached with the Government on: (1) the Government's provision of budgetary allocations for essential drugs; (ii) priority in the selection of trainees and fellows to be given to staff and key managers, especially women, from the districts covered under the project; (iii) a National Drug Policy to be developed by June 30, 1993 and incorporated into the National Health Policy, which would be submitted to the Ministerial Council during FY94; an essential drugs list to be adopted by December 31, 1994; (iv) plans for follow-up actions of the project's pilot activities and for implementing a policy on cost recovery for essential drugs. 16. Environmntal Apaects. The project is classified under the Environmental Category C: "No appreciable environmental impact". In the construction and essential drugs components of the project, measures will be taken to ensure that materials are selected, stored and used (and wastes are disposed of) in environmentally sound ways. 17. Program Objective Categories. This project will improve the quality of existing health services generally; specifically, it will improve the health conditions of people deprived of adequate health services, targeting women of -5- reproductive age and children, almost all of whom are poor. The project will also provide incentives for women to become providers of health care. The longer-term effects of reduced fertility and lower population growth rates should help to reduce disparities in living standards, alleviate poverty, and moderate the deterioration of the environment. 18. Project Aenefits. The direct and immediate benefits of the project which would be expected during the project implementation period would be: (i) improved quality and coverage of health care services for about 906,000 people residing in the seven project districts (especially at-risk rural populations); (ii) greater number of trained staff as some 7,000 personnel would be trained under the training component; and (iii) institutional development at both central and district levels of the MOPH. Innentives to attract and retain women as health care providers would include the opportunity to participate in the fellowship program and the provision of housing at the health centers in the seven project districts. The longer-term benefits of the project would be the establishment of a basis for more rapid expansion of quality health care coverage and possible models for a better delivery system based on the experience in the seven project districts and the pilot activities. Finally, the project can well be the springboard for mounting future, possibly sector-wide, projects. 19. Risk&. The principal risks are as follows. (i) The recruitment and retention of women as health care providers in the requisite numbers may not be realized, for cultural and socio-economic reasons. This risk would be minimized by strengthening health education messages which focus on women's participation in the health sector and by providing incentives to women to encourage their participation in training (fellowships) and to work in -heir own communities (housing). Moreover, the pilot activity on coaunity participation would include an assessment of ways in which the community might support women's participation in the delivery of services. (ii) There could also be resistance to the implementation of a national drug program because of a lucrative black market. The Government's commitment to a national program as expressed through the passage of appropriate legislation and the support of IDA and other donors committed to the development of a national program would mitigate the effects of this risk. (iii) The Government may not be able to finance the cost of maintaining facilities and equipment and of essential drugs on a nation-wide basis. In addition to the assurances contained in the project, the dialogue between IDA and the Government would be expected to result in additional allocation of resources to the health sector as well as more effective utilization of resources allocated to the sector. 20. Recommenda. I am satisfied that the proposed credit would comply with the Articles of Agreement of the Association and recommend that the Sxecutive Directors approve it. Lewis T. Preston President Attachments Washington, D.C. Date: June 4, 1993 -6- REPUBLIC OF YEME FAMILY HEAL PRO1ECT PROJECT COST AND FINANCINg PIAN (US$ million) Estimated Proiect Costs: conponent Local Foreign Total MECH/F? Services at PHC 3.9 7.7 11.6 Training & Health Education 0.9 2.3 3.2 Sector Management L2 2= Total Base Cost 6.5 18.5 25.0 Physical Contingencies 0.6 1.7 2.3 Price Contingencies QL _2-.Q2 Total Project Cost 8.0* 22.2 30.2 *Xnlluding tazs mad duties of US90.7 million. Financina Plan: FLnancigr Local Foreign Total IDA 4.4 22.2 26.6 Government 3. 0.0 3.6 Total 8.0 22.2 30.2 -7- SCHEMDUA Page 1 of 2 pages REP=BLIC YEMEN FAMILY HEAU= pEDJECI PROCUREMMET ME=HOD$ AND DISBURSEMENTS (US$ million) Procureme. Mbthod _ GATEGORY JCB LCB NB3- NTO Civil Works (a) Construction & - 8.6 - - 8.6 Rehabilitation (8.1)b - - (8.1) (b) Architectural & - - 0.5 ' 0.5 Engineering Fees - - (0.5) - (0.5) Furniture, Equipment, Vehicles & Materials 6.1 - 0.5 - 6.6 (6.1) (0.4)d (6.5) Pilot Activities - - 1.0 - 1.0 (1.0)0 - (1. 0) Consultant Services - - 1.4 - 1.4 = = (1.4)0 - (1.4) Studies - - 0.2 - 0.2 -- - (0.2)0 - (0.2) Fellowships - - 2.1 - 2.1 - - (2.1)0 - (2.1) Local Training - 1.5 - 1.5 (0.9)0 , (0.9) Essential Drugs 6.3 - - - 6.3 (5.9) - - - (5.9) Staff Salaries - - - 0.5 0.5 Operation & Maintenance - - - 1.5 1.5 Financing Requirement 11.9 8.6 7.7 2.0 30.2 IDA Financing (11.5) (8.1) (7.0) (26.6) 30": Figrs& in p4tanthes" are the =*unts to be financed by the IDA redit. a. Ion-IDA-finaced categories. b. Local oonpetilve blddig in a ccdance with proedure agred with IDA. * Pocuemet in accordfcee with the Ouideli" for the Use of Consultants by World Bank Borrows" ad by the wld bank as Executing Agency (August 1981). d. IntexntaUcel shoppidg for goods costiu les the US8100.000 pr contrgat (aggregate 1t00.000). -8. Page 2 of 2 pages EEPUBLIC OF -hER FAMILY HEALTH PROJECT Imm filCLCHEDULE (USM million) Allocation of Credit Proceeds! Credit ,Categp ry fllJhcattX _ Percentafe to be Financed (1' Civil Works (a) Construction & 8.1 lOO1 of foreign expenditures Rebabilitation and 50X of local expenditures (b) Architectural & 0.5 1001 Engineering Fees (2) Equipment, 6.0 1001 of foreign expenditures Vehicles-, 100 of local expenditures Furniture & (ex-factory cost) and Materials 85X of local expenditures for other items procured locally (3) Pilot Activities 0.9 1001 (4) Consultant 1.3 10Q Services (5) Studies 0.2 1001 (6) Fellowships 1.9 1O00 (7) Local Training 0.9 1001 of foreign expenditures and 501 of local expenditures (8) Pharmaceutical 1.4 FY95: 100l Products 1.2 FY96: 1001 1.0 FY97: 901 0.9 FY98: 801 0.8 FY99: 701 (9) Unallocated 1.5 - Total 26.6 - Estimated Digb=9n92=s: -IDA Fiscal Year l9 9 4m 1 179 ---------------------US$ million-------------------- Annual 0.2 1.4 9.4 6.8 4.8 2.2 1.8 Cumulative 0.2 1.6 11.0 17.8 22.6 24.8 26.6 Percentage 0 6 _ 40 66 84 92 100 SCHEDULEL REUBLC OF EMNn FA4ILY HU= PJC TIMETABLE OF KEY PROCESSING EVENTS (a) Time Taken to Prepare Project: 7 months (b) Project Prepared By: Borrower, with IDA assistance (c) First IDA Mission: July 12, 1992 (d) Appraisal Mission Departure: January 30, 1993 (e) Date of Negotiations: May 10-13, l993 (f) Planned Date of Effectiveness: January 1994 (g) Relevant PCRs: No. 9269: Health I (Credit 1294-YAR) No. 9926: Health I (Credit 1377-YDR) (h) Responsibilities for Preparation: Task Manager Alfonso F. de Guzman (MN2PH) Peer Reviewers Denis Broun (PHN) Frederick Golladay (EMTHR) Albert Sales (MN2PH) Division Chief Mr. Douglas H. Keare (MN2PH) Director Mr. Ram K. Chopra (MN2) Regional Vice President Mr. Caio Koch-Weser (MNA) -10- ASE=d 2 Page 1 of 2 RE:PBIC OF lEMEN STATUS OF BLA GROUP OPERATIONS A. STITT OF IDA CREDITS (As of March 31, 1993) arit in U%af lUt i - :o Credit Cr. 1o. FY sore r Project momt 2/ Utw ,,,.,................ .................... . .........,.... . . 58 cedits futly dibured 0.4 1019 96 Rehlf of Yaw gmti on IV 10.4 1.1 1UR ii0 2 R3Ptic of Y~ lan'o Urban ev.; 14.7 0.4 139 Ile SepmIC of Y_ Agrig. asaroh & G0W. 6.0 0.1 13 196 ROPlAc of yawn 1rAtfin 10.0 1.1 16 19go RaPtle of a a YUdO Ml . A4r 0e. 11 9.0 1.4 1413 19a IepubtSl of Yawn sigi"ws V 13. 03 14I 198 gep atMc of Y_ Urba ettr_t t 5.5 0.4 1u4 t9m R.lic of Yawn CuKtl HiShteds Afr. 8.0 2.9 1470 1984 bephti of r4n Uation VI 1.0 43 154? 19t S R3epuc offet Tea Inusrat i0v. II 5.3 1.0 156 195 aePAMo of et n Tredh. AssIstance 4.7 3.4 1is 9Ie RepaMlc of ymn Usdt At-lawf Agw.evD 10.0 13.4 161? 1aS AtpiMfc of Yaw 1G1I1ys IV 14.4 4.4 O 19a 6 Raeple eo Yemen Tedmfcat trilrde 132.7 13.6 16 196 RopilclI of r^n tiri l Rs. Ag. ev. V 10.0 10.0 171 19866 Rapuic of Yinn Ppow Iv 11.7 7.0 170. 986 lepic Of et me T.A. Petol 10.9 5.6 19 198? Raplc of Y_ Or. Aen Water tgPP It 3.6 4.2 1m IW Rtepic Of Yawn 38lWP W133 5.1 1m 73 1 R98? p t YMeof y_an Ir Traing 10.4 54 1an 196? eptic of 1n Fifth llt_ "6 10.7 1WA "9 Republic Of YOM Su Ill Noedeb Sd. 1 l. 10.7 4.9 1966 i198 Repi fc Of Yol h. It". Af. ew. 17.6 1.4 114 1989" lepbtic of Yawn Al Ni*Stta Wa S0PtY 13.0 10.7 170 199tWephIlo of yawn Yerlth Oev. I1 4.5 3.5 195 196o tmpRtic of r_mn Eaterm R". As. *W. 15.0 13A 3015 1989 gep ubic df Io mn Sot. OSw. for POA. Ad. 104 10.4 20e5 196 lipetic of Yemn Wed lid Aer. Ow. tti 12.0 1U.5 2307 1990 aep*Lf c of Y_n Iw. Flood berat. 10.0 7.6 31s5 19e R0epub" of lnn ltb Sector v. 5.0 . 230 199o gp1tf0 of r_n Taft Flood Ofes 15.O 1.2 3164 t99e. RtcLofl ad Y PowrI II f.5 163 3170 1990 lwep1*Llcof nTsa wYtar*pty 12.0 13A 3127 1991 lep1*tt c of Ya SAttlfW* 1inePrt 30.0 36 21 1991 beAIci of yan Sengty, tier 1? Tr 1 *9.4 UA we 1991 ftpbiMl of Tons Emrgawy Recovery 55.8 0. ma : 1991 Sep8b le of Ye n ro_tl palwin oaY. 13.2 1A 5/ 199 lp6bt9c of of n Tge. Seater Nt. PO 14.4 1448 otlts 9tA 3. Of uid has btn reaid 15.4 toutl "Wuts 11 Steat of pjects tlsted In Part A _ a #n4 s f epoe report er Olt ICA fieed prjet in _swtlefl uhAet is td tidig yweaty WUgifwlstod to th Ejeuti. Olrestoa on Apitl 30 ai ctober 31. 23 Crdits dausabnnted In MRS. mit *Um 1s USS qubvel*mt at eIa of teeo' atio' for th l a t. aWA the U evaetw a of larch 31 1991 f the mised_ -'ft. 3/ Mot We *ffective. -~ 11 - Page 2 of 2 REPUBLIC OF Y SSATU8 OF SANK GROUP OPERATIONS B. STATEMENT OF IFC INVE8sTMETS (As of March 31, 1993) (Aint in S mitlion) yewr obtior Type of Birne Loan Iqwity Total ............... ...................___.... _........................................................... .... ...... ..... ......... .. 78 YVan Dairy and Juice Products Dairy and 3.2 0.00 3.15 tnutries Co., Ltd. Juice Products 84.85 Yein lattery Nanufacturing Co. Nanufecture 3.3 0.9 4.2 of EteItrical A*pratus 85 lationat CapaW for Veetabte 0ft 4.? 0.0 4.? V"etabte Oit d Shea industries 86 Yems Ht Oft Compan Oft Refinery 9.0 0.0 9.0 87 #arib Agricutturat Co. Ltd. Agr. & Livestock 2.4 0.3 2.7 Productiomn .... -. ...... Tot a Gros Cah2tmes 22.S 1.2 23.7 Les: Canceltnions, teinations, wrfteoffs, 16.8 1.2 18.0 repan ints, "tae ad excane adjustments ...... ...... ....... Totatl caittants now held by IfC S.6 -0.0 5.6 Totat Undisbreed (including participants prtion) 0.0 0.0 0.0 Totat Outstanding 5.6 ... 5.6 IDRD 24849 45' 48 51i, 90 0 0cTosnc 0 ~~ ~~~~~~~0 SaecwD IOWNSAND VBLAOES REPUBLIC OF YEMEN * o VECRNOPATECAMA3S FAMILY HEALTH PROJECT ox + * tzoN 18, PORS TO MM. SEC~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~OVENDA0R~OUADAS i [ }SAA~~~~~DAH GOVE *N/ /TE /OUD )ES 40, amoft~~~~~~~~~~~~~~~~~~ INTERNATONAl BOUNqDARES tA,t,, ~~~~~~~~~~AL .AW.F 51c vt/7 / O 4 HARAD t>AJJAH >H | 88 Zi~HemA D M.A A WT = Tisbut This map~ has been TI epored A1 rf by Th-e World s b stf I lxdSff Afor She c_ novenjiS NII lf r=Ader sand is for Ohm interal une of The WoeddB GruThe d,oDnnattans = ishn ad the boondodes show RIB o)y A.tment on ot t aPI N~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ OTT tStOq 050 S ~~~~~~~~~~~~'A r wxbr~~~~~~~~~~~~~~~~~~~~~ndoment oracco 7ot Atoq A,\\owdah boo RE SA InYd 0~~4 57- -0 11e 1Z SOC OTRA 4T ~~~~~~~~~~~451 41r 54- l2-1 JUNE 1993