Healthcare facilities combating the effects of climate change – Post Hurricane Lisa

Belize

Photo: PAHO/WHO Belize Country Office Solar panel at the Independence Polyclinic installed during retrofitting.

Healthcare facilities remain operational against climate disasters

Health facilities in Belize are vulnerable to natural hazards and the effects of climate change. This often results in weather-related disasters which may impact the capacity of health facilities, both functionally and structurally, to provide critical and routine services. PAHO/WHO Belize, through the support of UK-FCDO, implemented the Smart Health Facilities in the Caribbean intending to update and adapt health facilities in the region to cater to natural and climate disasters, enabling them to continue to provide emergency care to victims and ongoing healthcare for other communities. Following the passage of hurricane Lisa in November 2022, PAHO/WHO Belize provided technical support with the use of the rapid assessment form of health facilities post-emergency and disaster to identify full functionality of various health facilities including Cleopatra White Polyclinic, one of the retrofitted facilities. With hurricane Lisa mainly affecting the central region of Belize, Cleopatra White Polyclinic was the main facility to be assessed. However, the five health facilities retrofitted as ‘smart hospitals’ remained functional during and after hurricane Lisa made landfall [1]. There was no disruption of utilities and service delivery continued for both emergency and routine needs. Hence, following this success, further support was received to expand the initiative of retrofitting of other health facilities.

Key WHO Contributions

Conceptualization of Smart Hospitals initative
Development of technical directives to guide operationalization of initative
Delivery of trainings to capacitate local officials on retrofitting
Inspection of facilities following disasters to assess effectiveness of retrofit.

How did Belize, with the support of the PAHO/WHO Secretariat, achieve this?

According to the Plan of Action for Disaster Risk Reduction 2016-2021, 77% (13,566 /17,618) of the hospitals in the AMRO/PAHO Region are in areas of potential climate risk and require urgent remedial measures to protect personnel and patients’ lives during and after a disaster. As extreme weather events become more prevalent, vulnerabilities in systems will become more evident. Health systems are amongst the most vulnerable to climate variability. The consequences of a health facility post-disaster include the inability to provide emergency care and ongoing healthcare for communities. Healthcare facilities are also intensive energy users due to the services provided and equipment used. Knowledge of the condition of the facilities, their level of exposure, and their role within the health service network is indispensable. Certain conditions can therefore be created to mitigate these vulnerabilities before the effects are manifested.

Because of this, AMRO/PAHO through the support of UK FCDO, established the Smart Hospitals Initiative in the Caribbean which focuses on improving hospital resilience, strengthening structural and operational aspects, and providing green technologies. Energy improvements include solar panel installations, electric storage batteries, and low-consumption electrical systems, which, in addition to reducing energy consumption, reduce the health sector's carbon footprint in the environment and provide the hospital with energy autonomy, allowing it to continue running during emergencies and disasters. Healthcare facilities are smart when they link their structural and operational safety with green interventions, at a reasonable cost-to-benefit ratio.

PAHO/WHO Belize supported the Ministry of Health and Wellness and other partners to implement this initiative through the application of guidelines and toolkit for retroﬁtting existing facilities. The toolkit provides a step-by-step guide and includes the Hospital Safety Index (HSI), Baseline Assessment Tool (BAT), and green checklist and utilizes cost-beneﬁt analysis to support investment decision-making. To complement this, training was provided to the national authorities on the use of the toolkit, maintenance, conservation, contingency planning, and procurement procedures.

^{PAHO/WHO personnel, Dr. Edwin Bolastig and Ms. Alondra Izaguirre, along with the Director of Public Health and Wellness, Dr. Melissa Diaz-Musa, assessing Cleopatra White Polyclinic post-hurricane Lisa.}Photo credit:PAHO/WHO Belize Country Office.

Following hurricane Lisa in November 2022, considerable damage was reported in its path. Although the health sector was also impacted, the five health facilities retrofitted as ‘smart hospitals’ remained functional during and after the hurricane made landfall. No structural damage was identified, and no power or water disruption was reported, thanks to the smart (safety and green) interventions implemented under the initiative.

‘In terms of natural disasters, the retrofitting will help us a lot. For the fact that whenever we have heavy rain or disasters, we would have to be packing up everything in plastic bags including medications and equipment and raising them off the floor from flooding and leaks and now that doesn’t have to happen because of the retrofitting.’

Nathalie Brown, Pharmacist at Cleopatra White Polyclinic

They were able to serve their catchment populations, especially those who were affected by the hurricane. Critical services such as immunization, sexual, maternal, and child health care, chronic medical services, and others were accessible to communities. The required infrastructure and critical systems such as electricity through solar power, water supply via rainwater harvesting, drainage system, and others provided the backup system for the facilities to remain operational to those in need, including those with COVID-19.

‘We had some ongoing leakage from the ceiling, but the majority of that has been solved. One of the other aspects was the protection of the windows. Every hurricane season we use to get wood and nail them to protect the windows then take it down. Now, we have shutters that are easy to open and close and it’s permanent and I call that ‘smart’.’

Dr. Rayford Rancharan, Medical Coordinator/Director of Independence Polyclinic

Smart Hospitals have already shown their cost-effectiveness and resilience to disasters in other countries. In 2013 in St. St. Vincent and the Grenadines, following heavy rains, Georgetown hospital, having benefited from the smart hospital initiative became the only functional health facility after a severe storm affected 39 clinics and the main reference hospital. In addition, Georgetown hospital became a water supply center for the community after the storm, using rainwater reserves.

Through the initiative, PAHO/WHO Belize has been able to increase the resilience of the health system in the country. These renovated facilities are now safer, greener, and more resilient to the impact of natural hazards and climate change. Furthermore, PAHO/WHO was able to seek additional funding support from the European Union, which will enable the retrofit of an additional four health facilities in Belize, expanding the smart standards for disaster and climate resilience.

References

Hurricane Lisa Situation Report 4 - Pan American Health Organization