Why keep health facilities safe?
Safe health facilities in emergencies are a collective responsibility
Hospitals are more than just buildings. They are a vital asset at the heart of a community, the place where often life starts and ends. Due to the central role played by hospitals in our communities, we all share the responsibility of making sure they are resilient in the face of emergencies. Below are three reasons as to why we must make hospitals safe in emergencies.
1. Save lives, protect health
As they are occupied 24 hours a day, hospitals cannot be evacuated easily. They must remain working if their occupants – especially the most vulnerable such as newborn babies and patients in intensive care – are to survive. When the work of hospitals and other health facilities is disrupted or their buildings are damaged, both urgent and routine health care is interrupted and may be halted altogether – leaving the sick and injured without the care that they need.
Health "systems" rely on a range of public, private and nongovernmental facilities to work together to serve the community. In times of emergency, this is even more important. Hospitals, primary health care centres, laboratories, pharmacies and blood banks work with other non-health sectors, including energy, roads and transport, and the police to ensure the continuity of health services.
Health facilities are safe havens for people during an emergency. Hospitals and their staff must be regarded by all parties – particularly combatants during conflicts – as neutral and must not be subjected to any form of violence. Sadly, the provisions of international humanitarian law in this regard are often not respected. During emergencies, health facilities play a vital role. They:
- provide emergency care to the injured (e.g. surgery and blood transfusions) and to the critically ill – as in outbreaks of communicable disease;
- collect and analyse data on illness and deaths in order to detect and prevent potential communicable disease outbreaks;
- deliver longer-term health care before and after an emergency. People need long-term nursing and medical care, maternal and child health services, rehabilitation of injuries, management of chronic diseases, and psychosocial support long after the emergency is over;
- provide immunization services to prevent outbreaks of communicable diseases such as measles that lead to the needless deaths of more children; and
- provide other critical services – including laboratories, blood banks, ambulances, rehabilitation facilities, aged care facilities, and pharmacies.
2. Protect investment
The most costly health facility is the one that fails. Hospitals and health facilities are enormous investments for any country and their destruction or damage imposes major economic burdens. In some countries, up to 80% of the health budget is spent on hospitals and other health facilities. Rebuilding a hospital that has been destroyed virtually doubles the initial cost of the facility.
3. Safeguard social stability
Public morale can falter and political discord be ignited if health and emergency services fail during emergencies. Conversely, an effective emergency response and functional health service can reinforce social stability and cohesion. Hospitals are a haven for the public during conflicts and other emergencies due to their neutrality, impartiality and ability to protect a community's social and health capital.
Disasters are also politically important and their handling affects public confidence. Perceived inadequacies in the emergency response to Hurricane Katrina in New Orleans, USA, in 2005 reduced public confidence in government when the country witnessed 44 dead bodies being recovered from a hospital that had been flooded, damaged and abandoned. At least 140 elderly patients of hospitals and nursing homes died in the wake of the hurricane.
On the other hand, approval ratings for President Alan García of Peru rose following the government's effective management of the Peruvian earthquake in 2007. The Peruvian government indicated that hospital needs were covered one week after the quake. China's leadership instilled public confidence by directing emergency response efforts from the scene of the 12 May 2008 earthquake in Sichuan Province.