altThe Pan American Health Organization (PAHO/WHO), in association with Ministries of Health in the Region, promotes the Safe Hospitals initiative as an effective mechanism to save lives when disaster strikes; together, they have made significant advances in recent years. Currently, there is a growing demand for safe hospitals, as well as greater political will. An increasing number of countries have national policies on safe hospitals and are using their own resources to fund their national programs on safe hospitals.

In South America, at least eight countries have included Safe Hospitals within their Ministries of Health’s Disaster Programs.

Ecuador is working on strictly enforcing a national policy for the construction of new public health facilities, using the Safe Hospitals standards. It is also incorporating the private sector into the process, through the Association of Private Hospitals and Clinics of Ecuador (ASHPE) and is integrating the subject in other sectors’ institutions. In addition, the Ministry of Health continues with the evaluation of health units; to date at least 67 hospitals have been evaluated using the Hospital Safety Index (HSI).

Paraguay encourages health units to have emergency plans to better respond to the multiple emergencies that affect their country. The Ministry of Health and Social Wellbeing already has teams with evaluators trained in the application of the HSI, and its work is also focused on turning the theme into a multisectoral and interinstitutional strategy that includes new actors and has a legal framework and more resources available.

In Peru, the Safe Hospital National Committee has an available budget of US$ 20 million (this amount has been incrementally increasing since 2011). Currently, there are vulnerability studies in place in 14 hospitals in Lima, and other actors—such as Social Security, who also have facilities in the Safe Hospitals program—have joined.

In Colombia, the Ministry of Health and Social Protection continues the evaluation of hospitals using the HSI and is working to make the results accessible through a virtual platform. The country is also instituting a Safe Hospital’s degree and is working on the disaster component update in their Virtual Library.

In Central America, countries continue to achieve significant progress regarding Safe Hospitals; disasters offices in the ministries of health are pivotal elements in this process.

In El Salvador, the Vulnerability Secretariat has adopted the initiative as a priority issue and, with the support of the Ministry of Health, has incorporated it into national policies to ensure that the health sector is able to continue providing services during and after disasters. The country has evaluated 84% of high- and medium-complexity health facilities, and 226 low-complexity establishments.

In Costa Rica, the Social Security agency has defined a policy at the national level. This has allowed not only the rehabilitation of some establishments, but also the construction of new facilities using Safe Hospitals parameters. The country has evaluated 80% of their high- and medium-complexity facilities.

Guatemala is working in the strategic prioritization and assessment of health facilities, through alliances between the Ministry of Health and PAHO/WHO with universities and engineering and architectural associations. The objective is to achieve a stronger national policy.

In Honduras, Nicaragua and Panama, resolution projects to form a Safe Hospital National Commission are already included at the decision-making policy levels; even though it is a long process, the first step has been taken.

At the political level, the approval of an strategic plan for 2013–2018 by the Council of Ministers of Health of Central America and the Dominican Republic, which includes the subject of Safe Hospitals, is an achievement that will have repercussions at the highest levels of political commitment regionally.

Ministry of Health Nevis Permanent Secretary, Ms Angelica Elliot installing fire extinguisher at Alexandra Hospital, Nevis.

In the Caribbean, since 2008, and as part of the Safe Hospitals initiative, approximately 40 health facilities have been evaluated. Of these 80% are in Category B, indicating that the hospital’s current safety levels are such that patients, hospital staff, and its ability to function during and after a disaster are potentially at risk.

Eastern Caribbean countries have performed, with support from PAHO/WHO and the Department of Humanitarian Aid and Civil Protection of the European Union, safety evaluations in ten of their hospitals. They have also implemented actions to improve non-structural and functional security of these facilities.

Since 2012, St. Vincent and the Grenadines, Dominica and St. Kitts and Nevis have focused their work to increasing resiliency and improving the capacity of their health workforce. As a result, they hope to strengthen their health networks to better respond to disasters. They have also done safety evaluations and improvement works in three of their hospitals.

Currently, several English-speaking Caribbean countries have projects, in eight hospitals, related to the improvement of internal communications, water storage capacity, access to the facilities, firefighting systems, among others. The emergency plans of these hospitals are also being revised to ensure an integrated response to multiple hazards.

The Dominican Republic is promoting the Safe Hospitals initiative at the national and provincial levels. The objective is to better respond to the increase in the demand to health services, particularly along the border with Haiti. In this context, five hospitals have been evaluated and their intervention plans have been prepared. A national policy on Safe Hospitals is also being prepared.