World Health Day

How to safeguard health facilities


Protect essential services, equipment, medicines

Problem

For health facilities to function properly in emergencies, non-structural elements must be in place. Such elements include mechanical, electrical and communications equipment, water and electricity supplies, medicines, and facilities for handling hazardous hospital waste.

If these are compromised, the health facility will not function during outbreaks, conflicts and natural disasters. Water had to be delivered by truck or extracted from bore holes, to health facilities in Zimbabwe during the cholera outbreak that commenced in August 2008 as the country's water infrastructure has been under great strain.

Likewise, many hospitals cannot deliver health care during emergencies because staff are not protected. Armed combatants clash with each other near health facilities and sometimes enter them, endangering staff and patients. Medical supplies are put at risk when conflict or natural disasters destroy or threaten central drug stores and other medical warehouses. Sometimes the hospital environment itself poses a threat to the safety of staff and patients, such as when infectious disease outbreaks occur. During the SARS epidemic in Asia, response efforts were complicated by the fact that in some locations approximately 40% of those infected were health workers.

Sudan: Hundreds of health facilities in Darfur have been unable to provide health care because many health workers were forced to flee areas affected by the conflict broke out in 2003. Equipment, reagents, generators and water tanks were looted or destroyed. The general insecurity in this area led to a decrease in access to health facilities.

In Iraq and Gaza, the failing infrastructure and faltering electricity networks have forced health facilities to rely on back-up generators during extended shortages of grid-based power. Medical and surgical equipment, such as incubators, and other basic services like air conditioning, require secure electricity supply to function. The situation can become even more precarious when diesel fuel for the generators is in short supply.

Solution

To protect infrastructure, equipment and staff, and to ensure patient security, thus allowing health facilities to function more effectively in emergencies:

  • Ensure that health facilities have a steady flow of safe water and electricity that can be assured during times of emergency
  • Properly enclose and secure power generators to make them more likely to function after a disaster. Powerful back-up generators, with sufficient supplies of diesel fuel stocked in different locations, and with access to more, are critically important in settings prone to emergencies that could disrupt the regular mains supply
  • Equip health staff with appropriate personal protection equipment for use during disease outbreaks
  • Store medicines and supplies in secure cabinets or in cupboards that are fastened to walls to make them more likely to withstand earthquakes
  • Protect pipes and ducts, and ensure a safe supply of gases, including oxygen
  • Secure medical and life-saving equipment, such as respirators or suctioning devices, to make them less likely to disconnection during emergencies
  • Ensure that voluntary non-remunerated blood supplies continue during emergencies
  • Strengthen security for health staff and denounce the deliberate targeting of staff and use of facilities by combatants in armed conflict
  • Ensure that voluntary non-remunerated blood supplies continue during emergencies
  • Provide a supply chain for medicines and laboratory supplies during an emergency
  • Secure alterative sources of supply as part of the overall health emergency response plan
  • Ensure that there are systems to manage hazardous substances, including chemical, biological and radiological waste.
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