Hospitals Safe from Disasters:

1. Hospitals Safe from Disasters: Elisaveta Stikova, Ronald LaPorte, Faina Linkov, Margaret Potter, David Piposzar, Sam Stebbins Reduce Risk, Protect Health Facilities, Save Lives

2. Learning Objectives • To introduce student with UN/WHO joint campaign for disaster reduction and safe hospitals • To enlighten the Hyogo Framework of Action and the 2008-2009 disaster reduction campaign • To explain the role of WHO in joint activities to promote disaster reduction campaign • To clarify the 10 goals of World Health Day 2009 enlighten in WHO tool kit

3. SEE Public Health Preparedness Supercourse Network Elisaveta-Jasna Stikova • Present position • 1991-Present, Professor, University “Ss. Cyril and Methodius”, Medical faculty, Skopje, Macedonia (courses taught: Occupational Health, Public Health, Medical Ecology, Hygiene • 1994 – Present, Director and Advisor, National Public Health Institute, Skopje, Macedonia • 2009 – Fulbright Visiting Scholar, Pittsburg University, Graduate School of Public Health – New Educational Pathway for Global Public Heath Security

4. SEE Public Health Preparedness Supercourse Network Co-Authors and collaborators: • Ronald E. LaPorte, PhD, UPGSPH, Director, Disease Monitoring and Telecommunication, WHO Collaborating Center • Faina Linkov, PhD, Assistant Professor, Cancer Institute • Margaret Potter, JD, MS, Associate Dean and Director, UPGSPH, Center for Public Health Practice • David Piposzar, MPH, UPGSPH, PPLI Co-director • Sam Stebbins, MD, MPH, UPCPHP Principal Investigator/Director, Center for Public Health Preparedness

5. Hospitals Safe of Disasters The most costly hospital is the one that fails!!!

6. Hospital Safe from Disasters • Disaster means that basic needs of people exceed the available recourses of community • During disasters health facilities usually can’t serve to the needs of the population because of: • Increasing of demands • Decreasing of delivery capacities

7. World Health Day 2009 Hospitals Safe from Disasters: • Reduce Risk • Protect Health Facilities • Save Lives Safety of facilities Readiness of health workers to respond to the needs

8. Hospitals Safe of Disasters • Hyogo Framework for Action • to reduce our collective vulnerability to natural hazards • Disaster risk reduction is important action aims to achieve MDG • Disaster risk reduction is everybody's business • Only tangible measures can reduce vulnerability and protect development Ban Ki-Moon, UN Secretary-General

9. What is Hospitals Safe from Disaster Means? • Safe hospitals is more than physical and functional integrity of the health facility • Safe hospitals means to be prepared for functioning in full capacity, appropriate for the needs of the affected people, immediately after a hazard strike!!!

10. What is Hospitals Safe from Disaster Means? • A safe hospital means that: • It will not collapse in disasters • It can continue to function and provide its services as a critical community facility when it is most needed • It is organized, with contingency plans in place and health workforce trained to keep the network operational

11. What Are the Objectives of Hospitals Safe for Disaster Campaign? • Three main objectives of campaign: • Protect the lives of patients and health workers • Make sure health facilities and health services are able to function • Improve the risk reduction capacity including emergency management.

12. Why Focus on Hospitals Safe of Disasters? • Algerian earthquake, 2003 – 50% destroyed health facilities • Pakistan earthquake, 2005 - 49% destroyed health facilities • Peru, Pasco earthquake, 2007 - within two minutes, the city lost 97% of its hospital beds to an 8.0 magnitude earthquake. • China’s Wenchuan earthquake, 2008 – 11 000 health facilities (52%) were destroyed • Viet Nam flood, 2008 – 61 hospitals were damaged provinces • Fuji rains 2009 – flooded health facilities and devastate infrastructure

13. Hospitals Safe for Disaster10 basic facts to know - 1 • Many factors put hospitals and health facilities at risk: • Buildings • Patients • Hospital beds • Health workforce • Equipment • Services

14. Hospitals Safe for Disaster10 basic facts to know - 2 • Components of a safe hospitals or health facility: • Structural elements • Non-structural elements • Functional elements

15. Hospitals Safe for Disaster10 basic facts to know - 3 • Hospitals would be put out of services during disaster because of: • Structural damages • Functional collapse

16. Hospitals Safe for Disaster10 basic facts to know - 4 • Hospitals and health facilities can be built to different levels of protection: • Life safety • Protect of infrastructure and equipment • Operation protection

17. Hospitals Safe for Disaster10 basic facts to know – 5, 6, 7 • Making new hospitals and health facilities safe from disasters is not costly • Field hospitals are not the best solution for damaged and destroyed hospitals • Seeking the right expertise: a check consultant

18. Hospitals Safe for Disaster10 basic facts to know - 8 • Building codes are of utmost importance • One of the earliest mentions of the importance of building codes is found in Hammurabi’s Code 2: “… [if the builder] did not construct properly this house which he built and it fell, he shall re-erect the house from his own means.”

19. Hospitals Safe for Disaster10 basic facts to know - 9 • Creating safe hospitals means shearing responsibilities • Governments • Health institutions and health workforce • UN, international and local agencies and NGOs • Donor community • Financial institutions • University, schools and professional institutions

20. Hospitals Safe for Disaster10 basic facts to know - 10 • The most costly hospital is the one that fails!

21. Hospital Safety Index • Applicable tool for ranking of level of safety for each health facility/hospital • Structural components • Non-structural components • Organizational/functional components

22. Cost effectiveness of prevention • Building disaster safe hospitals is much cheaper in comparison of the consequences of destruction during disaster • Almost 50% of health facilities were destroyed during the recent disasters • Indirect cost of damaged health infrastructure can be higher than direct cost of replacement and rebuilding • The cost of the disaster safe hospital is only 4% added to the cost of the new facilities

23. Hospitals Safe of Disasters • The role of Universities, Schools and Professional institutions • Develop professional curricula, modules or courses that contribute to hospital safety • Act as repositories of specialized expertise • Publish articles for scientific and technical publications and journals • Contribute to the development and periodic review of national building standards

24. Hospital Safe of Disasters • Safe Hospital Strategy: • Strategic partnership • Risk reduction in health sector • Training and education • Develop tools and guidelines • Advocacy and awareness

25. Hospital safe of Disasters • Target Audience • Policy and decision makers, including in financial and planning sectors • Professional associations/unions (engineers, architects, administrators) • Hospital associations • The public, directly and through the mass media • Private and public managers of health systems • Health professionals worldwide