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Significant advances in health,
social and economical development have been made in
recent decades. And yet, this progress has been
repeatedly tested by man-made and natural disasters.
One cannot pursue long-term strategies for health
for all without paying attention to this global
problem.
Disaster is “any occurrence that causes damage,
economic disruption, loss of human life and
deterioration in health and health services on a
scale sufficient to warrant an extraordinary
response from outside the affected community or
area”. The response to a disaster must involve all
sectors of government and the whole community.
Functional health facilities and trained staff are
crucial in times of emergencies and disasters.
The World has long experienced many disasters and in
some of these, health facilities were a major
casualty. For example during December 26, 2004,
tsunami —30 of the 240 health clinics were destroyed
in Aceh province, Indonesia and seriously damaged 77
others. In Sri Lanka, 92 health facilities were
destroyed including 35 hospitals. In 2001 in
Gujarat, a magnitude of 7.7 earthquake destroyed
3812 health facilities. More than 11,000 medical
institutions were damaged in China’s Wenchuan
earthquake in May 2008, forcing tens of thousands of
people to seek treatment elsewhere. Current
conflicts in Ethiopia and Gaza are hampering primary
health services, such as immunization. These are
some examples of disaster situations where health
services are affected and at times unavailable when
needed the most.
World Health Day 2009 focuses on the safety of
health facilities and the readiness of health
workers who treat those affected by emergencies.
Health centers and staff are critical life-lines for
vulnerable people in disasters – treating injuries,
preventing illness and caring for people’s health
problems, such as safe child birth services,
immunization and chronic disease care, which must
continue in emergencies. Often, already fragile
health systems are unable to keep functioning
through a disaster, with immediate and future public
health consequences.
The focus of the biennial World Disaster Reduction
Campaign 2008-2009, is also on the same issue :
“Hospitals Safe from Disasters – Reduce Risk,
Protect Health Facilities, Save Lives”. In this
global effort World Health Organisation is working
with UN International Strategy for Disaster
Reduction (ISDR) and World Bank so that all
facilities stand upto emergencies and continue to
function.
On International Day for Disaster Reduction, 8
October 2008 in New York, experts from China, India
and Caribbean shared experiences with International
agencies, Diplomatic Missions and health sector
academics on how to make hospitals and schools safe
from disasters. India outlined a ten-point approach
to ‘Building Back Better’ from Gujarat’s massive
2001 earthquake, ranging from seismic risk
assessment to training masons and local communities.
It was the Disaster Mitigation Advisory Group (DIMAG)
that originally conceived the idea of Hospital
Safety Index, which is gaining acceptance as a
global tool for assessing the likelihood of a
hospital remaining functional in disaster
situations. A strategy should be developed to
sustain current efforts to apply the Hospital Safety
Index, including training the evaluators who use the
safe hospital check list to assess health
facilities. DIMAG will also promote creation and use
of learning tools and methodologies.
DIMAG proposes that future safe hospital measures
take into account the risks associated with climate
change such as flooding, stronger hurricane and
storm surge and increase awareness regarding these
hazards.
A fire safety guide for hospitals will be developed
and published and will include procedure for
evacuation exercise, as part of the Hospital
preparedness programme.
The Pan American Health Organisation (PAHO) and
DIMAG will encourage and lend support to the June
2009 Conference on ‘Safe Hospitals’.
Several countries are working to keep hospitals
safe, improving preparedness to protect lives. In
Mexico, trained evaluators have diagnosed the safety
of 200 health facilities, identifying which health
facility needs improvements. In Japan, Pakistan and
Peru health facilities are now build to withstand
earthquakes. Multifunctional facilities for health
education and agriculture are built in Bangladesh to
aid relief after cyclones and floods – which saved
thousands of lives after Cyclone Sidr in 2007. WHO
is also urging health facilities to respond to
internal emergencies, such as fires, and ensure the
continuity of care.
The goal of raising awareness in this issue is to
affect changes that will ensure that health
facilities are able to function in the aftermath of
emergencies and disasters. This means ensuring the
structural resilience of health structures with
existing technologies; keeping the equipment and
supplies of these health facilities intact should an
emergency happen; improving preparedness and risk
reduction capacity of health workers; and involving
communities in this effort.
Safe health facilities are those that are accessible
and function at maximum capacity immediately after a
disaster event. This is not just the work of the
health sector and health professionals alone but
experts from other fields such as urban planners,
architects, engineers to bring not just awareness,
but action.
Unfortunately, it is impossible to prevent most
disasters. Nevertheless, we can forestall or
alleviate many of their worst effects by
anticipating them and by being prepared. Our concern
is with reducing the adverse impact of disasters on
human health, through preparedness and by bringing
the right technology to bear in a timely,
coordinated and effective manner, for each phase of
operation, namely, relief, rehabilitation and
reconstruction. (PIB Features)
*Senior Scientist, Former Assistant Director,
National Environmental Engineering Research
Institute, Nagpur.
Disclaimer : The views expressed by the author in
this feature are entirely his own and do not
necessarily reflect the views of PIB
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