Call for Disaster-Safe Hospitals

Health ministers agreed to place high priority on making health facilities safer in the event of natural disasters, during the 45th Directing Council meeting of the Pan American Health Organization (PAHO) in September. The ministers resolved that, by 2015, all new and remodeled hospitals in the region should be designed, built and maintained so that they can continue to function after a disaster.

In a presentation to the ministers, Jean-Luc Poncelet, head of PAHO's disaster preparedness and response program, noted that hospitals are critically important in the aftermath of disasters, providing both lifesaving health services and a much-needed sense of security for the population. When hospitals are incapacitated, the risk of death or permanent handicap increases overall and especially among the sick and injured.

"Unfortunately, in many disasters, hospitals become inoperable when they are most needed," said Poncelet.

More than half of the 16,000 hospitals in the region are in high-risk areas, and many have been lost or incapacitated by earthquakes, hurricanes and floods. During El Salvador's 2001 earthquake, nearly 2,000 hospital beds (39 percent of the country's total capacity) were put out of service. Hurricane Mitch in 1998 damaged or destroyed 78 hospitals and health centers in Honduras and 180 in Nicaragua, while Hurricane Georges damaged or destroyed 87 health facilities in the Dominican Republic the same year.

More recently, "Grenada lost its entire health capacity in one blow with Hurricane Ivan," said Poncelet.

Yet improvements in building design and construction have proven effective in reducing the vulnerability of hospitals and other facilities to disasters. In recent decades, developed countries such as the United States and Japan have adopted building codes that require hospitals and other public facilities to be disaster resistant.

A recent PAHO report notes that 21 Caribbean and Latin American countries have also begun to address these issues. El Salvador is incorporating modern disaster mitigation principles into its designs for a newly rebuilt health services network. Costa Rica and Colombia have retrofitted hospitals to make them safer, and Colombia and Chile have adopted new laws that require disaster mitigation and prevention measures in the construction of new health infrastructure.

Pilot projects in low- and middle-income countries have shown that it is possible to significantly reduce vulnerability to disasters with existing knowledge and available resources.

"We will have safe hospitals when other sectors fully recognize that health facilities save lives and therefore must remain functional following disasters," Poncelet told meeting participants.

Citing the effects of the 2004 hurricane season in the Caribbean, he added: "We have to learn to live with nature. Hurricanes are terrible, but we just have to prepare for them."