As the world adjusts to the fallout of the global pandemic, emergency responders across the Caribbean were inundated by an overactive and destructive 2020 Atlantic hurricane season.
Kingston, 10 August 2020
The record-breaking 2020 Atlantic hurricane season has officially ended, however the effects will be felt for some time to come. It was the most active on record with 30 named storms, 13 developed into hurricanes, and six further intensified into major hurricanes, with one, Hurricane Iota, attaining Category 5 strength.
The Caribbean is prone to the effects of major hazards such as hurricanes, earthquakes and floods and with over two thirds of its hospitals located in areas of risk, it is important for countries to implement mitigation measures to enable continued service delivery.
Individuals, communities and entire populations alike, all want to have access to health care when they need it most - before, during and after any emergency and disaster strikes.
Building resilience
The Ministry of Health and Wellness, with the support of the Pan American Health Organization (PAHO) Jamaica country office, has advanced towards increasing the resilience of health centres across the country to withstand increased environmental threats.
Following the guiding principle Safe + Green = Smart, at least twelve health centres have been identified to receive retrofitting. Four Health Centres will undergo design and retrofitting to ‘Smart’ standards and at least eight will receive Smart Interventions.
The 46.3M pounds Smart Health Care Facilities project is being rolled out in seven Caribbean countries (Jamaica, Belize, Guyana, Dominica, Grenada, Saint Lucia and St. Vincent and the Grenadines), and is financially supported by the United Kingdom's Foreign, Commonwealth and Development Office (FCDO) and implemented through PAHO’s Health Emergencies Department in partnership with the Ministry of Health in each target country.
The expectation is that facilities will be safer and greener or ‘Smart’ at the end of the project, with a focus on increased protection from disasters and climate change.
Ongoing conservation and contingency planning training remain integral to the project deliverables with rigorous scheduling and implementation of daily checks for leaks, on-site maintenance and corrective actions, and the ability to monitor usage trends.
“Individuals, communities and entire populations alike, all want to have access to health care when they need it most - before, during and after any emergency and disaster strikes,” said Dr Marion Bullock DuCasse, PAHO Jamaica’s Health Emergencies Advisor. “This project ensures that through the systematic application of standards utilizing a Smart Hospitals Tool Kit, Ministries of Health and partners will be able to conduct assessments of health care facilities in four components – structural, non-structural, functional and green.”
The results provide a Hospital Safety Index (HSI) and Green Score. The HSI score informs on whether the health care facility will be able to withstand a disaster like a hurricane and remain functional, ranging from the optimal A score to a less than secure C score, meaning the facility will more than likely be damaged or destroyed and could endanger the lives of staff and patients.
Green standards include use of energy and water efficient equipment and fixtures, such as low-volume flush toilets and solar panels.
The recommendations serve as a guide to the improvements that must be taken to achieve the gold standard of an A 70+ score, with 70% being the minimum standard for the green component.
Green standards include use of energy and water efficient equipment and fixtures, such as low-volume flush toilets and solar panels. The recommendations serve as a guide to the improvements that must be taken to achieve the gold standard of an A 70+ score, with 70% being the minimum standard for the green component.
A recent example emphasizes how the rating system works. In the British Virgin Islands after Hurricane Irma in 2017, while other buildings failed, the Peebles hospital, an A 70+ rated building, remained functional allowing relief and recovery efforts of the Government to be coordinated from a conference room within the hospital.
In Jamaica, the four health care facilities being designed and retrofitted to Smart standards are St. Ann’s Bay, Port Antonio, Mandeville and Santa Cruz Health Centres. At least eight other Health Centres will have Smart interventions, to make them energy and water efficient with improvements such as increased water storage and installation of generators. This will make the facilities independently functional for at least five days if utility services are interrupted.
PAHO Support in Jamaica
Ongoing conservation and contingency planning training remain integral to the project deliverables with rigorous scheduling and implementation of daily checks for leaks, on-site maintenance and corrective actions, and the ability to monitor usage trends.
Since January 2020, the MOHW has been supported by PAHO to advance the project with the following key activities:
The tender process was started in June 2020 with bids due in July 2020 for:
- Three Health Centres for Smart Intervention with site visits in June 2020 of potential contractors, MOHW staff and PAHO Technical Consultants and Check Consultants – Gayle H/C, St. Mary, Albert Town H/C (including roof replacement), Trelawny and Darliston H/C, Westmoreland
- Five Health Centres for small, Smart Interventions with site visits in June 2020 of potential contractors and PAHO Technical and Check Consultants – Norman Gardens and Windward Road, KSA, Yallahs, St. Thomas and Sydenham and Cumberland Road, St. Catherine, from 10 – 11 June 2020.
The MOHW has previously benefitted from the following:
- Hospital Safety Index (HSI) and Green Check List Assessment training (85 persons);
- The Smart App training for assessments was piloted in Jamaica for 17 persons in 2018.
- Conservation training (25 persons) and Contingency training (22 persons) at five Health Centres initially selected for retrofitting, with development of plans for each area al the facilities;
- Market Engagement training for contractors (29 persons);
- Ancillary Staff training (24 persons);
- 146 of 150 facilities assessed - 76 facilities assessed by MOH (41% HSI B score; 59% C score, with green score average 28%) and 70 facilities by GW Architects.
- Design only for Stony Hill and Catherine Hall Health Centres
- Knowledge, Attitude and Practice baseline survey completed by MOHW at five Health Centres – St. Ann’s Bay, Mandeville, Port Antonio, Santa Cruz and Stony Hill (Awareness survey among staff and patients)
- Three Town Hall meetings were conducted - for the Port Antonio, Stony Hill and St. Ann’s Bay Health Centres on 8, 12 and 14 November 2018, respectively.
It is also planned for major retrofitting to start in 2020 at two of the four Health Centres selected for design and retrofitting.
As the hurricane season of 2020 is predicted to be more active than normal, PAHO will continue its technical cooperation programme with the MOHW guided by the three project outputs:
- Health facilities assessed in safe and green standards
- SMART standards implemented in selected health care facilities, and
- National and regional capacity to apply and promote climate smart health facilities standards enhanced