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Providing health care in times of crisis

14 October 2009 -- To mark the United Nations International Day for Disaster Reduction, we look at why hospitals must be ready to provide health care in times of crisis.

Transcript of the podcast

Paul Garwood: You're listening to the WHO podcast, and my name is Paul Garwood. To mark the United Nations International Day for Disaster Reduction, we look at why hospitals must be ready to provide health care in times of crisis.

The earthquakes, cyclones and tsunamis that struck the Asia and Pacific regions in recent weeks destroyed or damaged over 300 health facilities, leaving hundreds of thousands of people without adequate health care in the immediate wake of the tragedies.

On 30 September, an earthquake measuring 7.6 on the Richter scale hit off the Indonesian island of Sumatra. Among the casualties was one of the two buildings at the main hospital in the city of Padang, which collapsed, cutting off vital health services at the worst possible time.

WHO Indonesia emergency and humanitarian staff member Dr Vijay Nath describes what he saw.

Vijay Nath: The outpatient department and the screening department, the whole building went down, so half of the functionality of the provincial hospital, which is also a teaching hospital, is gone.

Paul Garwood: WHO teams were on the ground in Sumatra help to coordinate relief work, assessing the damage to the health system and organizing emergency medical care. Dr Vijay Nath explains.

Vijay Nath: With the international organizations we try our best to mobilize so that where the health services are struggling, challenging with their emergency phase of managing, we fill the gaps of mobilizing so we have mobile clinics. We have set up field hospitals where the hospital is damaged, including in Padang.

Paul Garwood: WHO has teamed up with the UN International Strategy for Disaster Reduction as well as the World Bank to ensure health care is available during emergencies. The three agencies have worked on the "Hospitals Safe from Disasters" initiative, which is the theme of the World Disaster Reduction campaign that ends on 14 October. Much has been achieved in the past two years. Global awareness is high about the need to protect health in disasters. A thematic platform on disaster risk reduction in health brings together world experts on what best to do to safeguard health from emergencies. Many countries are assessing their hospitals and clinics to see if they are safe from disasters.

Jonathan Abrahams works for WHO's Health Action in Crises Cluster in the Emergency Preparedness and Capacity Building Department. He tells us what governments can do to prepare for disasters.

Jonathan Abrahams: Assessment is important for existing health facilities but also action needs to be taken in the design and planning phase for new health facilities wherever they are being built. Staff need to be trained for their role in emergencies and they also need to exercise those plans so that when the emergency does occur they have practiced their role in providing the necessary care and support to the community.

Paul Garwood: WHO has introduced a simple evaluation guideline, currently implemented in hospitals in the American region, called the safety hospital index . It enables health facilities to evaluate their safety and probability of withstanding a disaster. Dr Jean-Luc Poncelet explains how this works.

Dr Jean-Luc Poncelet: What they have done in Mexico in the social security system is to make an inventory of all the facilities and apply the hospital safety index that was developed by WHO in order to know which hospital are in category A B or C (A being the better of the hospitals) - so they have a map of how many hospitals will resist the next earthquake in Mexico, for example.

Paul Garwood: Jet Li, WHO's Goodwill Ambassador, personally experienced the Southeast Asian tsunami in the Maldives, last year's earthquake in Sichuan and this years Typhoon Marakot in Taiwan. He witnessed first hand the breakdown in healthcare when hospitals fail in emergencies.

Jet Li (in Chinese with voice over in English): In the last 100 years we have over exploited our planet's resources causing many of today's natural disasters. Earthquakes, storms and flooding are becoming more and more common. So I am appealing to all governments and cities to build hospitals so safe they are able to withstand earthquakes and tsunamis and other types of environmental stress. In this way we are able to protect and save more lives.

Paul Garwood: If you would like more information about WHO's work in making hospitals safer or the World Disaster Reduction campaign, please see the links published on the transcript page of this podcast.

That's all for this episode of the WHO podcast. Thanks for listening. If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is

For the World Health Organization, this is Paul Garwood in Geneva.