PAHO Says Hospitals Should Stand Up to Disasters

Armen Hareyan's picture

Hospitals and other health facilities should be built to withstand the impact of natural disasters and should continue providing essential health services during and after emergencies, public health experts said today during a celebration of World Health Day at the Pan American Health Organization (PAHO).

“In disasters, hospitals should not be allowed to become victims too,” said PAHO Director Dr. Mirta Roses. “We know that with current knowledge, existing resources, and a strong political commitment, it is possible to reduce the impact of disasters, emergencies, and health crises on hospitals and health facilities. The cost is lower than what one might expect and far less than the price paid when health facilities fail at the time when people need them most.”

Saving lives and caring for the injured are the main priorities following any disaster, yet these critical functions depend largely on hospitals and health facilities that too often are crippled by disasters, experts said during a panel discussion.

In yesterday’s earthquake in central Italy, for example, parts of the main hospital in L’Aquila had to be evacuated, according to press reports. Following Hurricane Katrina in 2005, 17 of 20 New Orleans hospitals were rendered inoperable due to flooding. In the 1985 earthquake in Mexico City, an entire wing of Juarez Hospital collapsed, killing 561 patients, doctors, and nurses.

“Ironically as well as tragically, many of those health professionals were among the best prepared to respond to mass casualties,” said PAHO Director Roses. “Yet no amount of preparedness could compensate for a hospital that was simply unsafe.”

She noted that in Latin America and the Caribbean, more than half of all hospitals are located in areas that are at high risk of natural disasters.

In Geneva today, the World Health Organization (WHO) called on its member countries to undertake six core actions to make their health facilities safe during emergencies:

1. Assess the safety of hospitals
2. Protect and train health workers for emergencies
3. Plan for emergency response
4. Design and build resilient hospitals
5. Adopt national policies and programmes for safe hospitals
6. Protect equipment, medicines, and supplies.


PAHO has developed a Hospital Safety Index that is being used by a number of countries in Latin America and the Caribbean to assess the level of safety of their hospitals and health facilities, and to determine what steps are needed to improve their safety. Preliminary results indicate that nonstructural elements—architectural features and equipment, for example—contribute more to vulnerability than structural factors.

One of the most important lessons from Katrina was that generators and other critical utilities should not be located on the lower floors of health facilities, where they are most vulnerable to floodwaters, noted Milagros Kennett, staff architect of the U.S. Department of Homeland Security’s Building Science Branch.

She added that by the end of this decade, the United States will need to spend some $20 billion per year to replace, upgrade, or rebuild hospitals and health facilities.

Training of health workers is also a critical part of hospital preparedness, said Dr. Ruth Berggren, director of the Center for Medical Humanities and Ethics at the University of Texas Health Science Center. Berggren was a doctor on duty at Charity Hospital when Katrina struck in 2005 and had to care for patients for six days without electric power before being evacuated. Many doctors and other staff failed to report for duty before the hurricane, making the work of those who did much more difficult, according to Berggren. She said that personal preparedness training for health workers, including training in professional ethics, should be a central part of overall hospital preparedness.

Public-private collaboration in disaster preparedness is also critical, said Chris Van Gorder, president and CEO of Scripps Health, which operates five acute-care hospital centers in California. “Hospitals need to be part of local preparedness plans. We have to collaborate with local, state, and federal agencies, and for that to happen, we need to plan and practice in advance.”

Participants said that in addition to providing vital health services, hospitals have an important symbolic function, which is especially important for community recovery following disasters.

“Hospitals are a critical part of a community’s resilience,” said Rear Admiral W. Craig Vanderwagen, U.S. assistant secretary for preparedness and response. “These facilities’ ability to remain standing becomes central to a community’s sense of its own ability to recover.”

World Health Day is celebrated every April 7 to commemorate the founding of the World Health Organization (WHO) in 1948.

PAHO, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It also serves as the Regional Office for the Americas of the World Health Organization (WHO).