5. Hospitals safe from disasters
Sixty-seven percent of the health facilities in Latin America and the Caribbean are located in areas subject to disaster risk. On average, a hospital that goes out of service leaves some 200,000 people without health care, and the loss of emergency services during disasters considerably reduces the possibility of saving lives. As a consequence, over 45 million people in the Americas remained without health care for months, and sometimes years, between the years 2000 and 2009, as a result of damages directly caused by disasters.
With this in mind, the Directing Council of the Pan American Health Organization (PAHO) passed a resolution in 2004 that urged Member States to adopt national policies to ensure safe hospitals in disasters as a part of their risk reduction activities. This call from the health sector of the Americas was taken to the Second World Conference on Disaster Reduction (2005, Kobe, Japan), where the Hyogo Framework for Action was approved. One of the Hyogo Framework’s priorities is to lessen fundamental risk factors. It urges countries to invest in simple and well-known measures to reduce risk and vulnerability by applying appropriate construction standards to protect vital infrastructure such as schools and hospitals.
A safe hospital is a health care facility whose services remain accessible and functioning to its maximum productive capacity with its usual infrastructure in the immediate wake of an extremely destructive natural event.
The comprehensive concept of safety applies when a health facility has the maximum possible protection from a natural disaster. In other words, such a health facility has a physical plant that remains standing and is free of major damage (protecting the lives of its occupants), has facilities and equipment that continue operating (protecting investment), and continues to provide care essentially as effectively as before (protecting function).
Even if all this is achieved, it is still necessary to ensure that access routes to the facility continue to be operational. Other basic or critical services, such as drinking water, electricity, telecommunications, and others, must also continue to be available so that the hospital can function to full capacity without interruption and absorb the additional demand for care.
A health facility’s maximum installed capacity describes the maximum capacity that the facility is designed to run at, making optimal use of its maximum number of beds, staff and normally available supplies. Services should be provided in the same building as before the disaster, which is to say, without having to evacuate the facility, and it should be possible to expand the capacity of the hospital by including areas that are not normally used for providing care, such as auditoriums, waiting rooms, hallways, parking areas, etc.
The lives of patients, staff, and visitors to the health care facility must be protected from the moment of the emergency through the phases of response, rehabilitation, and reconstruction. Initially health care will be provided to the occupants of the facility, and immediately thereafter, to new patients who are injured or otherwise require medical care.