World Health Day

How to safeguard health facilities


Situate, design and build new health facilities

Problem

A health facility's location can doom it from the start. In high-risk coastal areas, cyclones or hurricanes not only generate powerful winds but can cause sea surges that drive massive amounts of water into anything in their path, flooding and destroying them, and washing some away entirely. Building hospitals in areas of high seismic and volcanic activity carries high risk, as China, Iran, Japan, Mexico, Pakistan and other earthquake-prone countries can attest. Locating health facilities near factories which may cause contamination should also be avoided.

Structural damage stops many facilities from providing health care during crises. Earthquakes and floods can damage a hospital's structure and its non-structural components, while hurricanes can tear off roofs. Damaged health facilities pose health risks to patients and staff and cannot remain open.

Solution

Location: A well-chosen site allows health facilities to keep functioning in emergencies. When choosing a site:

  • Choose locations for hospitals that are not exposed to the elements or are less prone to known hazards
  • Build away from chemical and other hazardous industrial plants that may contaminate the facility
  • Do not build near high-risk coastal areas, in flood plains or other low-lying locations that are prone to damage from hurricanes, floods or water surges, including rising sea-levels associated with climate change
  • Do not choose sites that are prone to landslide or on ground that amplifies ground-shaking from seismic activity
  • Ensure that the health facility has good access for pedestrians and vehicles, and that entrance and exit routes are protected from hazards

Design and construction: These structural techniques will help health facilities withstand hazards and operate in emergencies:

  • Build on high ground to avoid flood damage, or elevate floor levels by using multi-storey designs and piles or stilts
  • Design to provide resistance and stability against hazards known to threaten the area
  • Adhere to local building codes
  • Use building techniques such as “base isolation technology” by which a building is isolated from the ground oscillations in earthquakes
  • Use natural ventilation in order to provide air change that decreases the transmission of communicable diseases within low-cost health care facilities
  • Construct the building's external envelope, such as walls, doors, and roof coverings, according to regulations and standards to protect, for example, against strong winds
  • Design health facilities so all aspects of the building, from its various wards to medicine cabinets, are well integrated. Symmetrical designs can help health facilities withstand earthquakes and strong winds
  • Apply designs to allow staff to expand critical health services, such as intensive care and surgery, in order to manage the surge of patients in an emergency
  • Have independent consultants review the health facility's design and construction
  • Design health facilities for all major hazards they are exposed to. Designs should not be done separately for earthquakes and hurricanes; they should be done for both.
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