2010

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Safe Hospitals Programs

Dr. Ciro UgarteEmergency Preparedness

and Disaster Relief

2010

Hundreds of hospitals are affected by natural phenomena in the Americas

Hundreds of hospitals are affected by natural phenomena in the Americas

EARTHQUAKES• Peru, 1970• Guatemala, 1976• Mexico, 1985• El Salvador, 2001• Peru, 2007• Haiti, Chile, Mexico, 2010

HURRICANES• Jamaica, H. Gilbert, 1988• Dominican Republic, H. Georges, 1998 • Honduras and Nicaragua, H. Mitch, 1998• Grenada, H. Ivan, 2004• United States, H. Katrina, 2005• Guatemala, H. Stan, 2006• Nicaragua, H. Felix, 2007• Cuba, H. Gustav & Ike, 2008

OTHER PHENOMENA• Colombia, volcanic avalanche, 1985• Peru & Ecuador, El Niño Phenomenon, 1997• Argentina, floods, 2003• Haiti & Dominican Republic, landslides, 2004 • Mexico, floods, 2007• Mexico, Chile, Argentina, Pandemic H1N1 2009

EARTHQUAKES• Peru, 1970• Guatemala, 1976• Mexico, 1985• El Salvador, 2001• Peru, 2007• Haiti, Chile, Mexico, 2010

HURRICANES• Jamaica, H. Gilbert, 1988• Dominican Republic, H. Georges, 1998 • Honduras and Nicaragua, H. Mitch, 1998• Grenada, H. Ivan, 2004• United States, H. Katrina, 2005• Guatemala, H. Stan, 2006• Nicaragua, H. Felix, 2007• Cuba, H. Gustav & Ike, 2008

OTHER PHENOMENA• Colombia, volcanic avalanche, 1985• Peru & Ecuador, El Niño Phenomenon, 1997• Argentina, floods, 2003• Haiti & Dominican Republic, landslides, 2004 • Mexico, floods, 2007• Mexico, Chile, Argentina, Pandemic H1N1 2009

2010

Earthquake in MéxicoEarthquake in México

2010

Earthquake in El SalvadorEarthquake in El Salvador

Disaster Risk

Reduction

Forum (DRA Forum 2009)

Hospitals

Safe from

Disasters

2010

Hurricane in the Caribbean

2010

Hurricane in Jamaica

2010

Floods in ArgentinaFloods in Argentina

2010Disaster Risk Reduction Forum (DRA Forum 2009)Hospals Safe from Disasters

Volcanic Eruption in Montserrat

2010

Earthquake in Guatemala

2010

Earthquake in HaitiEarthquake in Haiti

2010

The problemThe problem

• More than 67% of the nearly 18,000 hospitals in Latin America and the Caribbean are located in areas at higher risk of disasters.

• Hospitals are a huge investment and represent more than 60% of the Ministries of Health Budget.

• Hundreds of them were destroyed as a result of major earthquakes, hurricanes, and floods, causing massive impact in health care and enormous economic loss for the health sector.

• More than 67% of the nearly 18,000 hospitals in Latin America and the Caribbean are located in areas at higher risk of disasters.

• Hospitals are a huge investment and represent more than 60% of the Ministries of Health Budget.

• Hundreds of them were destroyed as a result of major earthquakes, hurricanes, and floods, causing massive impact in health care and enormous economic loss for the health sector.

2010

From

Vulnerability Reduction in Health Facilities

to

Safe Hospitals

From

Vulnerability Reduction in Health Facilities

to

Safe Hospitals

2010

To urge Member States to adopt “Hospitals Safe from Disasters” as a national risk reduction policy, set the goal that all new hospitals are built with a level of protection that better guarantees their remaining functional in disaster situations,

and implement appropriate mitigation measures to reinforce existing health facilities, particularly those providing primary care.

45th Directing Council, 2004Pan American Health Organization

World Health Organization

To urge Member States to adopt “Hospitals Safe from Disasters” as a national risk reduction policy, set the goal that all new hospitals are built with a level of protection that better guarantees their remaining functional in disaster situations,

and implement appropriate mitigation measures to reinforce existing health facilities, particularly those providing primary care.

45th Directing Council, 2004Pan American Health Organization

World Health Organization

Agreement in the Americas

2010

“Integrate disaster reduction planning in the health sector; Promote the goal of Safe Hospitals to ensure that all new hospitals are built with a level of protection that better guarantees their remaining functional in disaster situations,

and implement appropriate mitigation measures to reinforce existing health facilities, particularly those providing primary care.”

Hyogo Framework for Action 2005–2015:

Building the Resilience of Nations

and Communities to Disasters

“Integrate disaster reduction planning in the health sector; Promote the goal of Safe Hospitals to ensure that all new hospitals are built with a level of protection that better guarantees their remaining functional in disaster situations,

and implement appropriate mitigation measures to reinforce existing health facilities, particularly those providing primary care.”

Hyogo Framework for Action 2005–2015:

Building the Resilience of Nations

and Communities to Disasters

2010

EuropeEurope

2010

South East AsiaSouth East Asia

2010

East Mediterraneanالطبيعية الكوارث من المأمونة المستشفيات

Hospitals safe from natural disasters

East Mediterraneanالطبيعية الكوارث من المأمونة المستشفيات

Hospitals safe from natural disasters

• Pakistan Earthquake in 2005 destroyed 388 of the 796 health services in the affected area.

• A Group of Experts was established to validate safe hospitals assessment tools and to elaborate a regional implementation framework.

• Electronic Atlas of natural and human-made hazards.

• Pakistan Earthquake in 2005 destroyed 388 of the 796 health services in the affected area.

• A Group of Experts was established to validate safe hospitals assessment tools and to elaborate a regional implementation framework.

• Electronic Atlas of natural and human-made hazards.

2010

Safe HospitalSafe Hospital

• Is a health facility whose services remains accessible and functioning, at maximum capacity and in the same facility immediately after a large-scale disaster or emergency.

• The key issue is in the level of protection!

• Is a health facility whose services remains accessible and functioning, at maximum capacity and in the same facility immediately after a large-scale disaster or emergency.

• The key issue is in the level of protection!

2010

Levels of ProtectionLevels of Protection

I. Life Protection (patients, health personnel and visitors)

II. Investment Protection (equipment, furnishings and utility services)

III. Operational Protection (maintain or improve the facility’s capacity to function).

I. Life Protection (patients, health personnel and visitors)

II. Investment Protection (equipment, furnishings and utility services)

III. Operational Protection (maintain or improve the facility’s capacity to function).

2010

Safe Hospitals StrategiesSafe Hospitals Strategies

• National and international agreements• Adoption of appropriate norms and standards• Promotion of other sectors participation• Incorporation of protection criteria at the hospital

design phase• Safety measures implementation in existing

health facilities• Emergency preparedness strengthening• Monitoring of national safe hospitals program

implementation

• National and international agreements• Adoption of appropriate norms and standards• Promotion of other sectors participation• Incorporation of protection criteria at the hospital

design phase• Safety measures implementation in existing

health facilities• Emergency preparedness strengthening• Monitoring of national safe hospitals program

implementation

2010

Some Countries InitiativesSome Countries Initiatives

• Colombia: development• Costa Rica: fires• Chile: new investments• Peru: civil defense• El Salvador: reconstruction• Bolivia: guidelines• Cuba: international seminars• Nicaragua: national committee• Mexico: certification• Andean Community: Disaster reduction priority

• Colombia: development• Costa Rica: fires• Chile: new investments• Peru: civil defense• El Salvador: reconstruction• Bolivia: guidelines• Cuba: international seminars• Nicaragua: national committee• Mexico: certification• Andean Community: Disaster reduction priority

2010

Existing FacilitiesExisting Facilities

• Retrofitting all vulnerable facilities is unrealistic in most countries

• The cost of retrofitting can be as high as 40% of the replacement value

• Retrofitting all vulnerable facilities is unrealistic in most countries

• The cost of retrofitting can be as high as 40% of the replacement value

2010

Traditional Hospital Vulnerability Assessment

Traditional Hospital Vulnerability Assessment

• Hazard and Vulnerability Analysis• Structural Assessment• Non Structural Assessment• Equipment and Critical Lines Studies• Organizational/Functional Evaluation

Disaster Mitigation Advisory Group (DiMAG)

• Hospital Safety Index

• Hazard and Vulnerability Analysis• Structural Assessment• Non Structural Assessment• Equipment and Critical Lines Studies• Organizational/Functional Evaluation

Disaster Mitigation Advisory Group (DiMAG)

• Hospital Safety Index

2010

Hospital Safety IndexHospital Safety Index

• Safe Hospitals Checklist

• Mathematic Model (Safety Index Calculator)

• Hospital Safety Index

2010

Safety IndexSafety Index

• The Hospital Safety Index provides a snapshot of the probability that a hospital or health facility will continue to function in emergency situations.

• By determining a hospital’s Safety Index or score, countries and decision makers have an overall idea of its ability to respond to major emergencies and disasters.

• The Hospital Safety Index does not replace costly and detailed vulnerability studies.  However, because it is relatively inexpensive and easy to apply, it is an important first step toward  prioritizing a country’s investments in hospital safety.

• The Hospital Safety Index provides a snapshot of the probability that a hospital or health facility will continue to function in emergency situations.

• By determining a hospital’s Safety Index or score, countries and decision makers have an overall idea of its ability to respond to major emergencies and disasters.

• The Hospital Safety Index does not replace costly and detailed vulnerability studies.  However, because it is relatively inexpensive and easy to apply, it is an important first step toward  prioritizing a country’s investments in hospital safety.

2010

Functional Safety

LOW55%

HIGH20%

AVERAGE25%

Assessment Resultsfor the first 395 hospitals

Category A 36 %Category B 48 %Category C 16 %

Assessment Resultsfor the first 395 hospitals

Category A 36 %Category B 48 %Category C 16 %

Hospital Safety Index

0.47

0.53

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

1.00

Hospital ...

Ind

ex

Safety index: 0.47 Health Facility Status: Category B

Safety indexCategory

TypeWhat should be done?

0 – 0.35 Category CUrgent measures to protect the life of patients and hospital staff

0.36 – 0.65 Category BNecessary measures are required in the short term to reduce losses

0.66 – 1 Category APreventative measures are required to maintain and improve safety

2010

23 Countries in the Region are already applying the Hospital Safety Index

23 Countries in the Region are already applying the Hospital Safety Index

• Anguilla• Barbados• Bahamas• Belize• Bolivia• Costa Rica• Cuba• Dominica• Dominican Republic• Ecuador• Grenada• Guatemala

• Anguilla• Barbados• Bahamas• Belize• Bolivia• Costa Rica• Cuba• Dominica• Dominican Republic• Ecuador• Grenada• Guatemala

• Honduras• Jamaica• Mexico• Montserrat• Panama• Paraguay• Peru• Saint Kitts and Nevis• Saint Vincent & the

Grenadines• Suriname• Trinidad and Tobago

• Honduras• Jamaica• Mexico• Montserrat• Panama• Paraguay• Peru• Saint Kitts and Nevis• Saint Vincent & the

Grenadines• Suriname• Trinidad and Tobago

2010

Plan of Action on Safe Hospitals 2010 - 2015

Plan of Action on Safe Hospitals 2010 - 2015