Humanitarian Health Action

Purpose statements for panels and sessions

WHO Conference on the Health Aspects of the Tsunami Disaster in Asia

Panel 2.12: The health sector contribution to disaster reduction


The health sector encompasses all actors, public or private, central or local, civilian or military, dedicated to improving public health. The term ‘health sector’ refers to the entire system—from the most sophisticated university hospital to the smallest clinic at the community level. The ministry of health is the national entity responsible to ensure the basic population health rights. Disasters were considered frequently as act of God and hence were beyond reasonable state control. We know that people are not killed by the earthquake of the Tsunami. There are killed by a badly constructed building or by being in submersible area at the moment of the tidal wave. Disasters are characterized by WHO as a sudden event in which the needs to be attended overwhelm the local capacity. The classic way to attend it is by having first class external health responders reaching massively the affected area. However the Tsunami as many prior disaster have demonstrated that although the external assistance is useful it can only arrive as fast as the faster transport means which is almost always far above the first 6 hours in which medical assistance makes the most difference.

Several Latin American and Caribbean countries have reduced the number of hospital at risk of collapsing in case of disaster by strengthening existing ones or improving the way new hospitals are built. India, Nepal, Turkey and others have experts and institutions with the knowledge to advice authorities to reduce the risk at which the health system and services are exposed too. The impact of reducing the number of life lost in the tsunami affected areas has been the greatest in the areas that counted with functioning health facilities and services. The reason why health service doesn’t collapse is also due to the contribution of sectors that are ensuring that health services operates. E.g. Hospitals to be functional must have water, electricity and sterilization. Local response team to be effective must have access road and communication.

The creation of the International Decade for Natural Disaster Reduction in 1989 by the UN Assembly and the formation of the ProVention Consortium by prestigious agencies at the initiative of the World Bank have been strong ally in assisting among other the health sector in ensuring that critical facilities remain functional after disasters. ISDR have selected “safe hospitals” has an objective to be reached by 2015 and ProVention has made guidelines for hospitals on the protection of life, investment and function.

This session will look specifically at the ways to reduce the risk of the health sector to hazards with other means that external humanitarian assistance and preparedness. It will discuss the social and cost efficiency of reducing health risk from a multi sectorial point of view. I will identify key recommendations for countries and international agencies to reduce the health risk to disaster.

Discussion questions

  • How cost effective is risk reduction compared to immediate response operation?
  • Is risk reduction accessible/affordable to moderate and low income countries?
  • What is the support provided by international financing institution to reduce health disaster risk?
  • What would a sector such as the health sector need to invest to reduce its risk?
  • What would be public cost of such a program versus its potential benefit at medium term?
  • What do we need to have Safe Hospitals?