7.3. Improving structural safety
Columns, beams, walls, slabs, foundations and other components form the structural elements that are part of the system that supports a building. Structural engineers should conduct both the assessment and design of these elements. Click here to take a short virtual tour through a ‘safe’ hospital.
The use of the Hospital Safety Index to assess structural elements in health facilities (including an analysis of the geotechnical properties of soil where appropriate) helps to assess the safety of a facility’s physical structure and determine whether it will be able to continue providing services to the population in the event of a disaster or whether its structural integrity could be compromised, thus affecting its functional capacity. Read more about the structural elements to be assessed in the Safe Hospitals Checklist.
Given the results of the structural assessment, either based on the Hospital Safety Index or on vulnerability studies, corrective measures can range from simple repair of cracks to expensive retrofitting processes, or even further specialized studies. Again, political support is very important to ensure the resources for structural work—primarily retrofitting in a country’s high-priority strategic hospitals. Political will has been in evidence in countries in the Americas such as Colombia, which assessed its major hospitals and mandated their strengthening and in Costa Rica, where major hospitals were strengthened. Subsequent earthquakes demonstrated how timely the work was.
Based on the findings resulting from the application of the Hospital Safety Index, disaster mitigation measures should be consistent with current engineering practices and codes for each country. Measures should also take into account how the building is used and occupied. The mitigation work itself should be undertaken in such a way as to so as to have as little impact as possible on the facility’s normal operation. Here, too, coordination at every level is important so that interventions are completed in the given time and do not interfere with the provision of health care, and so that human resources are properly coordinated.