Hospitales inteligentes


According to the Plan of Action for Disaster Risk Reduction 2016-2021, 77% (13,566 / 17,618) of the hospitals in the Region are located in areas of risk and require urgent remedial measures to protect personnel and patients’ lives during and after a disaster. Hospitals follow building codes from the 80s and 90s, which are focused on seismic resistance, without considering climate change.

The AR53 Report of the International Panel for Climate Change indicates that in the following years extreme weather events will occur (heat waves, storms, floods, droughts, forest fires) that will cause a decrease in available water, reduction in food production and increase of diseases transmitted by vectors and others, which will make the vulnerability of ecosystems and human systems much more evident. Health systems will be amongst those most vulnerable to climate variability (according to the AR5 Report, with a very high level of confidence). The effects of climate change are variable; however it is necessary to create conditions to reduce vulnerabilities before the effects are manifested.

PAHO has been providing technical assistance to Caribbean countries for the implementation of the Smart Hospitals initiative in phases I and 2 (2012-2014 and 2015-2020 respectively).


The Smart Hospital initiative builds on the Safe Hospital Initiative and focuses on improving hospitals resilience, strengthening structural and operational aspects and providing green technologies. Energy improvements include solar panels installations, electric storage batteries and low-consumption electrical systems, which, in addition to reducing energy consumption, reduce health sector carbon footprint in the environment and provide the hospital with energy autonomy, allowing it to continue running during emergencies and disasters.

Smart Hospitals have already shown their cost-effectiveness and resilience to disasters. In St. Vincent and the Grenadines, Georgetown Hospital (benefiting from the intervention of a Smart hospital) was the only one that remained functional after a severe storm affected 39 clinics and the reference hospital (Milton Cato Hospital). In addition, this hospital became a water supply center for the community after the storm, using rainwater reserves.

Although the Smart Hospital concept has not been implemented in Latin America, countries of the Region are aware of the Safe Hospital initiative, as well as the Hospital Safety Index, which is widely disseminated around the world.

Smart Hospitals must have




  • Sound Roof & Foundation
  • Improved Security & Signage
  • Secured Equipment & Fuel Storage
  • Protected & Efficient Doors and Windows
  • Good Drainage
  • Back-up Power
  • Water Reserve
  • Disaster Management Plans
  • Comprehensive Maintenance Planning
  • Disability Access



  • Reduced Downtime
  • Resilient Structure
  • Reduced Operating Cost
  • Improved Safety
  • Satisfied Patients and Staff
  • Environmentally Sound Operations
  • Improved emergency care and services for the community

Environmentally sound 


  • Water Efficiency
  • Waste Minimization & Management
  • Pollution Reduction
  • Rain Water Harvesting
  • Alternative Power Using Renewable Energy
  • Efficient Lighting & Cooling
  • Improved Indoor Air Quality

Smart Health Care Facilities in the Caribbean Project

Natural hazards and climatic extremes, like hurricanes, earthquakes, floods and storm surge can cause significant disruption of health services and economic losses. Downtime, during and after an extreme event, limits the ability of health facilities to provide emergency care to victims and ongoing healthcare for their communities.

Many health facilities in the Caribbean are in areas of high risk and need strengthening in the face of repeated damage or increasing climate threats. Health care facilities can also be large consumers of energy, with a significant environmental footprint. With energy prices in the Caribbean among the highest in the world, savings could be better used on improving services.

The 'Smart Health Care Facilities in the Caribbean' project, funded by the UK Department for International Development (DFID) was implemented by PAHO/WHO in partnership with the Ministries of Health in target countries. A regional building code annex, guideline and toolkit for retrofitting existing or new facilities was developed and tested in two countries. The toolkit provides a step by step guide and includes the Hospital Safety Index (HSI), Baseline Assessment Tool (BAT), and Green Checklist and utilizes cost-benefit analysis to support investment decision making. Scale up of the project, also supported by DFID, is being implemented in seven Caribbean countries: Belize, Dominica, Grenada, Guyana, Jamaica, Saint Lucia and Saint Vincent and the Grenadines.

The purpose of this project will be to provide safer, greener health facilities to deliver care in disasters. The results expected from this project are mentioned below:

  • The first output: healthcare facilities will be assessed for disaster safety, water and energy consumption. This will provide a roadmap for risk reduction investment as well as green measures and be incorporated into the national risk exposure database of each country.
  • The second output: standards will be implemented in selected health care facilities in Belize, Dominica, Grenada, Guyana, Jamaica, Saint Lucia, and St. Vincent and the Grenadines.
  • The third output: national and regional capacity will be developed to promote climate smart health facility standards. This includes health workers and users of facilities; other sectors and climate change platforms or programmes; technical stakeholders (construction, engineering; architects etc.) and media. 

Guides and publications


Smart Health Care Facilities in the Caribbean Project - Phase II Flyer

The 'Smart health care facilities project flyerSmart Health Care Facilities in the Caribbean' project, funded by the UK Department for International Development (DFID) was implemented by PAHO/WHO in partnership with the Ministries of Health in target countries. A regional building code annex, guideline and toolkit for retrofiting existing or new facilities was developed and tested in two countries. The toolkit provides a step by step guide and includes the Hospital Safety Index (HSI), Baseline Assessment Tool (BAT), Green Checklist and utilises cost-benefit analysis to support investment decision making. 

Click here to access the document. 

Smart Hospital Flyer - Save Energy: Ventilation and Cooling 

Save Energy Ventilation and CoolingIt has been proven that natural light is much healthier than artificial light. This flyer explains the time of the day and locations were people could take advantage of using natural light and with what frequency and what level of brightness artificial light can be used.

Click here to access the document. 

Smart Hospital Flyer - Save Energy: Lighting 

Many Save energy lightingCaribbean buildings are built in a way to allow good natural ventilation, because they were built at a time when no air condition units were available. This flyer explains the different procedures to be carried out in order to obtain the best climate from natural air and the appropriate use of the air conditioner system. 

Click here to access the document. 

Smart Hospitals Toolkit

Health care facilities are smart when they link their structural and operational safety with green interventions, at a reasonable cost-to-benefit ratio. This Toolkit is comprised of previously developed instruments such as the Hospital Safety Index, which many countries are using to help ensure that new or existing health facilities are disaster-resilient. The Green Checklist and other accompanying tools support the Safe Hospitals Initiative and will guide health officials and hospital administrators in achieving smart health care facilities.

A practical guide for hospital administrators, health disaster coordinators, health facility designers, engineers and maintenance staff to achieve Smart Health Facilities by conserving resources, cutting costs, increasing efficiency in operations and reducing carbon emissions.


Materials about how hospitals can withstand disasters 

The countries of Latin America and the Caribbean are exposed to various natural and manmade hazards. We must be able to rely on our hospitals and health centers in all circumstances to avoid an increase in the number of victims after an event. This material, in French, includes a Guide, a training tool for using the guide, a questionnaire with a list of potential elements that can fail, and a short brochure with the key elements of the guide. The guide and accompanying materials have been designed specifically to aid in the construction of hospitals in Haiti, but the patterns shown may be of use to many countries and communities.


Radio Show on Disaster Reduction

"Vida que te queremos tanto" (Life, we love you so much) is a series comprised of four radio soap operas produced by the United Nations Office for Disaster Risk Reduction. It aims to increase awareness about how communities can address disaster risk reduction, to promote community safety and resilience in emergencies, and to increase the welfare and safety of citizens.


Caribbean Wind Hazard Maps Aid in Siting of Hospitals

State-of-the-art wind hazard maps for Caribbean islands and nearby coastal areas of Central and South America are critical aids when designing where to locate a new health facility or rebuild a damaged one.


Design Wind Speed Maps for the Caribbean

Towards the end of 2017 there was a rethink of the wind hazard levels following the very active and severe hurricane season of that year. A decision was taken in 2018 to initiate a formal review of the wind hazard throughout the Caribbean Basin.