In Latin America and the Caribbean, health facilities continue to be built in high-risk areas without proper protective measures
Washington, D.C., Sept. 29, 2010 (PAHO) — Ministers of health from throughout the Americas called today for new efforts to make hospitals safer in disasters so they can continue providing health services at times of urgent need.
The health leaders, meeting at the Pan American Health Organization (PAHO) in Washington, D.C., endorsed a new regional plan that includes planning, investments, and oversight systems to ensure that new hospitals and other health facilities are built and equipped to be disaster-resilient, and that older facilities are upgraded to be able to remain operational.
Reports from PAHO member countries indicate that 67 percent of existing health facilities in the Americas are located in disaster risk areas, and that new health facilities continue to be built in these areas. This is because most countries lack up-to-date standards, oversight mechanisms, and the administrative power to guarantee the safety and continuous operation of health facilities.
Data are not available on how many facilities in high-risk areas are vulnerable to disasters. However, evaluations of 327 hospitals in 17 countries using the "Hospital Safety Index" found that only 36 percent of assessed hospitals had a high probability of remaining functional following a disaster. Sixteen percent required urgent measures because they were considered unlikely to be able to protect the lives of patients and health personnel in the event of a disaster.
When a hospital is rendered inoperative during a disaster, the loss of emergency services makes it more difficult to save lives. Moreover, for every failed hospital, on average 200,000 people are deprived of health care for months and sometimes years.
In Haiti's earthquake in January of this year, 22 hospitals were seriously damaged and eight were destroyed in the three most-affected regions. Field hospitals—which took days or weeks to set up—provided limited health services to survivors needing medical attention.
In Chile's February 27 earthquake, 79 out of 130 hospitals in the affected area were damaged, for a total loss of some 4,700 hospital beds. Most hospitals that suffered serious damage were older structures that had not been upgraded to reduce their vulnerabilities to disasters. Many of these were near, and in some cases just meters away from, new hospitals that had been built to "safe hospital" standards and suffered little or no damage.
The action plan approved today calls on all PAHO member countries to:
- Establish national "safe hospitals" programs that set priorities for investments and include the participation of all concerned institutions and sectors.
- Develop systems to track new construction, repairs and improvements in health facilities, and establish transparency mechanisms for financing and execution of health infrastructure projects.
- Create systems for supervision and control, and develop a cadre of experts on the structural, nonstructural, and functional safety of health facilities to staff them.
- Develop a legal framework to ensure that new facilities and support services have the basic conditions to keep operating in the event of disasters.
- Develop technical guidelines for locating health facilities and for damage mitigation measures, to be included as terms of reference in bidding tenders for design, construction, and operation. Develop safety standards to be incorporated into health facility financing agreements.
- Improve the safety of existing health facilities, giving priority to those that are an essential part of the health services network during emergencies and disasters.
In approving the new regional action plan, ministers of health noted growing public demand and political will for safe hospitals, illustrated by a number of national and international commitments in this area. Colombia, Ecuador, Mexico and Peru, among others, have adopted national safe hospital plans, while other countries are drafting or updating legislation on the design and construction of health facilities to withstand disasters and the operation of these facilities in disaster situations. At least 24 countries and territories in the Americas have trained evaluation teams in the use of the Hospital Safety Index, and hundreds of hospitals have been assessed.
The PAHO Directing Council brings together ministers of health and other high-level delegates from throughout the Americas each year to set priorities for Pan-American cooperation in health and to guide PAHO's technical cooperation programs in its Member States.
PAHO was established in 1902 and is the world's oldest public health organization. It works with all the countries of the Americas to improve the health and quality of life of the people of the Americas and serves as the Regional Office for the Americas of the World Health Organization (WHO).
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