A disaster, above all, relates to people as it affects their state of physical, mental and social wellbeing. Destruction, even if it is sudden and massive, is not a disaster unless there are repercussions for the population. In this context, health services are essential 24/7, for all women and men, anywhere in the world.

In disaster situations, the main responsibilities of the health sector are to save lives, reduce permanent disability, provide medical services to the injured, and reduce the risk of disease and death due to illness or other health risks. These responsibilities can only be carried out if the health services remain fully operational.

Protecting hospitals and other critical health infrastructure from disasters not only limits the damage and physical and economic losses, but also allows for the continuation of essential services in the affected communities. When people have guaranteed access to public health services, we are contributing to the eradication of poverty and hunger, as affected families will not have to use their scant resources for health care in locations far from home—adding to their burden the cost of transportation and lodging, or having to seek services in expensive private institutions.

Since boys and girls are the most affected by disasters, having safe hospitals will reduce child mortality produced by adverse events. It will also ensure that maternity control and birth services continue functioning, which will contribute to two of the Millennium Development Goals that are most difficult to achieve.

Health services also help in the protection of other priority population groups, such as older people, the infirmed, displaced populations, native communities, and those living in extreme poverty. The main causes of death and disability in these groups are diseases like HIV/AIDS and malaria. Extending services to these groups will also continue the advances towards achieving other Millennium Development Goals.

The main challenge in the framework for action post-Hyogo, is the definition of tangible and attainable objectives

Having a health post in a community, or a hospital in a large city, that is safe from disasters, will not only protect the population, but will also serve as an incentive for the protection and intervention of other critical infrastructure.

As of today, significant advances have been made. Countries have access to the Hospital Safety Index, a low-cost tool that assesses the likelihood that a hospital will continue functioning after a disaster. At least 10% of the 17,600 hospitals in Latin America and the Caribbean have been assessed, and action has been taken to improve those in the medium- and low-level categories of safety. In addition, the Ministers of Health adopted a regional plan to ensure that all new hospitals are built to be safe from disasters.

These advances, however, cannot hide the fact that there are still major challenges. The main one, in the framework for action post-Hyogo, is the definition of tangible and attainable objectives. Professionals working in disaster risk reduction should adopt practical and reasonable proposals that can gain support from authorities, the mass media and the communities. These proposals should not isolate the problems of the environment, but should consider it, which is imperative not only to understand, but also to reduce vulnerability.

For this purpose, the health sector should include, in addition to traditional actors, others with whom to prepare multisectoral proposals with common objectives that will address the complexity of the problems, based on the multiple root causes of vulnerability. This will be the only way to build a society where community resilience is successful enough to coexist with natural hazards. PAHO/WHO is committed to a future with sustained and adequate capacity, led by the countries, which will reduce the risk of disasters to the health sector. In this way damage to the infrastructure and health services will be prevented, and the health sector will be able to provide timely and effective response after emergencies and disasters.

Disaster risk is unacceptable when it has a substantial and overwhelming effect on the health of people. This is why special attention should be given to these aspects, within the framework for action post-Hyogo.