Health, Disasters and Risk
Health facilities and services
Title: A practical tool for the preparation of a hospital crisis preparedness plan, with special focus on pandemic influenza
Author(s): By Enrico Davoli
Source: World Health Organization, Regional Office for Europe (WHO/EURO), 2006
Pages: 34 p.
Abstract: The usefulness of drafting a Crisis Preparedness Plan (CPP) is now undisputed. This document aims to offer a practical tool for planning appropriate measures to be adopted by a hospital and/or more generally a health facility in order to be better prepared to face a critical situation. The tool is the result of concerted contributions of various experts in the field of emergency services management. The recommendations provided are tailored to a medium-to-large hospital with various specialties included, and should be adjusted as appropriate at the different levels of health care of the health facility. This document provides a list of issues that are considered by the contributors as essential themes that must be tackled in all CPPs for hospitals. Each issue represents concepts and problems that are likely to be universally present in all critical situations, emergency or disasters and cannot be set aside when drafting the CPP. The document provides specific measures and hints for preparedness in the event of communicable disease epidemic, such as the possible influenza pandemic.
Title: A structural vulnerability assessment of hospitals in Kathmandu Valley
Author(s): By the National Society for Earthquake Technology (NSET) Nepal, World Health Organization (WHO), Epidemiology and Disease Control Division (EDCD), Ministry of Health, Department of Health Services, Nepal
Source: NSET, WHO, EDCD, 2002
Pages: 110 p.
Abstract: The report summarizes the study and assessment of the structural vulnerability of 14 hospitals in Kathmandu Valley and outlines recommended mitigation measures to improve resilience and performance.
Title: “Build back better”: reconstruction and rehabilitation strategy, health sector
Author(s): By the Earthquake Reconstruction and Reconstruction Authority (ERRA), Government of Pakistan (GOP)
Source: ERRA, GOP
Pages: 52 p.
Abstract: ERRA’s health policy delineates guiding principles, guidelines and strategy for reconstruction in the earthquake-affected districts. The health component of Government’s ‘Build Back Better’ policy is based on the Humanitarian charter for minimum standards for health care, including the right to ‘health for all’ and respect of the dignity of the population affected by the disaster. The health strategy has been constructed on the key principles of equity, access to essential health care, timeliness, results, accountability, placement of strong local leadership and strategic coordination of the effort. The strategy also envisages addressing the special needs of vulnerable population, especially women and children who are the major clients of the health system, and the needs of persons with disabilities and psychological trauma.
Title: Design for survival coordination of critical infrastructure interdependencies to maximize disaster survival
Author(s): By the Joint Infrastructure Interdependencies Research Program (JIIRP), University of British Columbia (UBC)
Source: JIIRP-UBC Team, 2005
Pages: 39 p.
Abstract: At present each infrastructure knows very well what to do when problems occur within its system: how to readjust operation while repairs are being made. Risk analysis and reliability studies are done internally on each infrastructure, but do not consider the dynamic combined effect of the other infrastructures. When large disasters occur, multiple infrastructures are damaged simultaneously. The coordination of their interdependencies becomes critical for effective repair actions without stepping on “each other’s toes”. The document proposes to focus on incorporate the interdependency links into the problem solution, facilitate decisions coordination among infrastructure managers during large disaster situations, and strengthen the interdependency links to design more resilient global infrastructure systems.
Title: Disaster mitigation for health facilities: guidelines for vulnerability appraisal and reduction in the Caribbean
Author(s): By the Pan American Health Organization (PAHO), World Health Organization (WHO), Humanitarian Aid Office of the European Commission (ECHO)
Source: PAHO/WHO, ECHO, 2000
Pages: 56 p.
Abstract: Based on the Caribbean experience these guides intend to show an analysis of the vulnerability of the health care facilities and how to apply mitigation measures. Although directed toward health personnel in hospitals and health centers, the guides are written in generalized language to be easily comprehensible.
Title: Disaster mitigation guidelines for hospital and other health care facilities in the Caribbean
Author(s): By the Pan American Health Organization (PAHO), World Health Organization (WHO)
Source: PAHO/WHO, 1992
Pages: 92 p.
Abstract: This booklet has been prepared for non-engineers, such as building owners, health care officials, managers, and maintenance personnel. Its twoflod purpose is to inform those officials involved in the planning, operation and management of health care facilities of the potencial magnitude of the impact caused by natural hazards, and to provide a useful tool to assit them in the risk mitigation of existing facilities and in the reliable design of new constructions.
Title: Disaster risk reduction and preparedness for health facilities
Author(s): By the World Health Organization Centre for Health Development (WHO Kobe Centre), Japan
Source: WHO Kobe Centre, 2007
Pages: 25 p.
Abstract: Health facilities, including hospitals, are facilities exposed to natural hazards. Considering the critical need for these institutions in the aftermath of disasters, priority should be put on identifying and reducing the weaknesses of existing facilities and on improving the building standards for new construction. When it comes to disaster resiliency standards, the bar is inevitably raised in the case of health facilities: not only should they remain structurally viable but they must also allow the continuity of healthcare activities. This literature review was prepared to assess the extent of our knowledge on health facility disaster risk reduction and disaster preparedness to better achieve the goals of the Hyogo Framework for Action by identifying the priority areas of action for the WHO Kobe Centre.
Title: Field manual for capacity assessment of health facilities in responding to emergencies
Author(s): By the World Health Organization (WHO)
Source: WHO, 2006
Pages: 186 p.
Abstract: This manual serves as an updated second edition to the publication Protocol for assessment of health facilities in responding to emergencies published by WHO in 1999. This updated second edition is a management tool for health professionals evaluating the preparedness of their respective health facilities for dealing with disasters. The needs of professionals who manage health facilities, including national and provincial emergency coordinators and regional emergency focal points, were kept in mind during revision of the original manual. The book is divided into three main parts. The main questionnaire found in the first part and presented in a checklist format will provide an overview of the health facility's present capabilities. The second part, Assessment of general emergency preparedness, deals with aspects of preparedness in any level of emergency. The third part, Assessment of preparedness for specific emergencies, is the major additional to this updated edition. This section tackles specific emergencies that are becoming increasingly relevant. Definitions, evaluation checklists and relevant case studies are provided whenever possible.
Title: Guía para la protección de establecimientos de salud ante desastres naturals
Author(s): By the Ministerio de Salud del Perú, Pan American Health Organization (PAHO), World Health Organization (WHO)
Source: Ministerio de Salud del Perú, 2005
Pages: 72 p.
Abstract: Esta publicación presenta criterios básicos, elementos y recomendaciones que se deben seguir, desde la planifi- cación del proyecto, su desarrollo y su puesta en funcionamiento para asegurar que se cuente con instalaciones seguras en casos de desastres naturales. Ha sido preparada en base a las experiencias en el Perú en mitigación, rehabilitación y reconstrucción antes y después del fenómeno El Niño de 1991 y el terremoto que afectó el sur del país en 2001. Es imperativo que los países adapten normas de diseño y construcción internacionales a sus propias necesidades para asegurar la protección de la vida, la operación y la infraestructura, y esta publicación es un paso en la dirección correcta.
Title: Guidelines for earthquake resistant construction of non-engineered rural and suburban masonry houses in cement sand mortar in earthquake affected areas (draft)
Author(s): By the Earthquake Reconstruction and Reconstruction Authority (ERRA), Emergency Architects, UN-Habitat
Source: ERRA, 2006
Pages: 34 p.
Abstract: The objective of these guidelines is to provide the necessary concept and know-how to the communities and local construction workers for earthquake resistant construction of non-engineered rural and suburban houses using locally available materials in earthquake prone regions of Pakistan. These guidelines are targeting government officials, partner organizations and trainers and may be used as technical reference. It will be the basis of training and capacity building.
Title: Guidelines for prevision against wind in hospitals and health centers
Author(s): By Carlos Compañy
Source: Pan American Health Organization (PAHO), World Health Organization (WHO), 2002
Pages: 37 p.
Abstract: During the design process the structural engineer must assure that the building will be able to resist the lateral loads imposed on the structure. Usually in Latin American countries the lateral loads utilized for design are those produced by earthquakes. Thanks to research conducted in the field of earthquake engineering, technological advances, and experiences during the past years it is possible to design and build structures capable to withstand most of the earthquakes that could take place in our region. However, sometimes it is the wind load instead of the seismic load that governs the design. This document has been prepared with the objective of providing to the engineers and architects of Honduras with theoretical and practical guidelines that can be helpful for designing and building safer hospitals and health centers against wind effects.
Title: Guidelines for seismic vulnerability assessment of hospitals
Author(s): By the National Society for Earthquake Technology (NSET) Nepal, World Health Organization (WHO)
Source: NSET, 2003
Pages: 122 p.
Abstract: Thess guidelines are for assisting health-sector professionals and authorities to implement qualitative assessments of structural and non-structural earthquake vulnerability of hospitals and health institutions. Additionally, disaster risk managers, who are responsible for hospital emergency preparedness, may also use these guidelines as a tool for understanding the tasks and directing their implementation.
Title: Guidelines for the use of foreign field hospitals in the aftermath of sudden-impact disasters: International meeting, Hospitals in Disasters, Handle with Care, San Salvador, El Salvador, 8-10 July 2003
Author(s): By the Pan American Health Organization (PAHO), World Health Organization (WHO)
Source: PAHO/WHO, 2003
Pages: 20 p.
Abstract: A field hospital is a “mobile, self-contained, self-sufficient health care facility capable of rapid deployment and expansion or contraction to meet immediate emergency requirements for a specified period of time. The field hospital may be temporarily dispatched with personnel or donated without personnel…Field hospitals are deployed only: a) following an appropriate declaration of emergency and a request from the health authorities of the affected country; b) when they are integrated into the local health services system; and c) when the respective roles and responsibilities for their installation and operational sustainment have been clearly defined.” Field hospitals are used to substitute or complement medical systems in the aftermath of sudden-impact events that produce disasters for three distinct purposes: to provide early emergency medical care (including Advanced Trauma Life Support; this period lasts only up to 48 hours following the onset of an event), provide follow-up care for trauma cases, emergencies, routine health care and routine emergencies (from day 3 to day 15), and act as a temporary facility to substitute damaged installations pending final repair or reconstruction (usually from the second month to two years or more).
Title: Guidelines for vulnerability reduction in the design of new health facilities
Author(s): By Rubén Boroschek Krauskopf, Rodrigo Retamales Saavedra
Source: Pan American Health Organization (PAHO), World Health Organization (WHO), 2004
Pages: 106 p.
Abstract: When struck by large-scale natural disasters, hospital services are interrupted temporarily or permanently, mainly due to damage to their infrastructure. The operational loss of these facilities signifies more than the loss of the capital investments. Far more importantly, it has a major negative impact on the wellbeing and the socioeconomic development of the population and the country. This publication, produced in conjunction with the PAHO/WHO Collaborating Center for Disaster Mitigation in Health Facilities at the University of Chile, puts forward three potential levels of protection from adverse events, or performance objectives: life safety, investment protection, and functional protection. It seeks to spread far a new vision of the conception and construction of public health infrastructure. It is directed to health-sector managers, professionals, and technical consultants entrusted with managing, designing, building, and inspecting new health facilities.
Title: Guidelines on non-structural safety in health facilities
Author(s): By the Epidemiology and Disease Control Division (EDCD), Ministry of Health, Department of Health Services, Nepal, and World Health Organization (WHO)
Source: EDCD, WHO, 2004
Pages: 24 p.
Abstract: The guidelines contain a discussion of the essential role of health services immediately following a medium or large-scale earthquake, and an outline of the possible threat to lives and functionality of the health facilities stemming from damage to non-structural components. Most importantly, the guidelines contain a series of illustrated mitigation measures that are low-cost and easy to implement as part of the day-to-day maintenance of health facilities.
Title: Health facility seismic vulnerability evaluation: a handbook
Author(s): By the Disaster Preparedness and Response Programme (DPR), Division of Country Support, Country Policies, Systems and Services (DCS/CPS), World Health Organization, Regional Office for Europe (WHO/EURO)
Source: WHO/EURO, 2006
Pages: 56 p.
Abstract: Given the importance of an effi cient response to emergencies and the need for a functional health care infrastructure in the aftermath of a disaster, hospital administrators must assess a facility’s vulnerability to earthquakes and obtain estimates of existing risk levels in order to ensure a proper response to emergency needs. A reliable and comprehensive hospital assessment can be carried out only by taking into account all three main vulnerability categories – structural, nonstructural and administrative/organizational – in that order.
Title: Hospitales seguros ante inundaciones
Author(s): By the Pan American Health Organization (PAHO)
Source: PAHO, 2006
Pages: 98 p.
Abstract: Este documento expone los efectos más comunes de las inundaciones en los servicios de salud y brinda recomendaciones técnicas para aplicar en prevención, mitigación, rehabilitación y reconstrucción de la infraestructura de salud vulnerable a inundaciones. Estas intervenciones permitirán reducir el impacto, brindar una respuesta y atención oportuna y eficaz, y facilitar la continuidad en la prestación de los servicios de salud, justo cuando la demanda se incrementa a consecuencia del evento. Esta publicación es el producto del trabajo de un amplio número de expertos y equipos multidisciplinarios de profesionales de América Latina. Está dirigido al personal técnico y de gerencia del sector salud.
Title: Hurricane Katrina, volume one, emergency response: hospital decision making in the wake of katrina, the case of New Orleans
Author(s): By Lucy Arendt and Daniel Hess
Source: Multidisciplinary Center for Earthquake Engineering Research (MCEER), 2006
Pages: 76 p.
Abstract: The report is volume one in a series detailing post-Katrina field investigations by the MCEER team. The study examines New Orleans hospital decision-making as it relates to disaster preparedness and emergency response, and focuses on the 15 acute care hospitals that were the primary providers of patient care in the New Orleans area before the hurricane struck.
Title: Hurricane Katrina, volume three, health and environmental issues: public health and environmental infrastructure, Implications of Hurricanes Katrina and Rita
Author(s): By James N. Jensen and Pavani Ram
Source: Multidisciplinary Center for Earthquake Engineering Research (MCEER), 2007
Pages: 31 p.
Abstract: The report is volume three in a series detailing post-Katrina field investigations by the MCEER team. The public health and environment reconnaissance team visited the Gulf Coast from October 17, 2005 to October 22, 2005. The team’s efforts extended from New Orleans to the parishes north of Lake Pontchartrain to the Louisiana-Texas border. The primary study areas were Orleans, Jefferson, St. Tammany, Washington, Calcasieu, and Cameron parishes. The report provides information on the public health aspects of the site visit and reviews the environmental infrastructure observations.
Title: Incremental seismic rehabilitation of hospital buildings: providing protection to people and buildings
Author(s): By the Federal Emergency Management Agency (FEMA)
Source: FEMA, 2003
Pages: 87 p.
Abstract: This manual provides healthcare organizations with the information necessary to assess the seismic vulnerability of their buildings and to implement a program of incremental seismic rehabilitation for those buildings. The manual consists of three parts: Part A, Critical Decisions for Earthquake Safety in Hospitals, is for healthcare organization senior executives, board members, hospital directors, vice presidents for facility management, and other policy makers who will decide on allocating resources for earthquake mitigation. Part B, Planning and Managing the Process for Earthquake Risk Reduction in Existing Hospital Buildings, is for hospital facility managers, risk managers, and financial managers who will initiate and manage seismic mitigation measures. Part C, Tools for Implementing Incremental Seismic Rehabilitation in Existing Hospital Buildings, is for facility managers, or others responsible for facility management, who will implement incremental seismic rehabilitation programs.
Title: Mobile health units in emergency operations, a methodological approach: network paper, number 60, June 2007
Author(s): By Stéphane Du Mortier, Rudi Coninx, Humanitarian Practice Network (HPN), Overseas Development Institute (ODI)
Source: ODI, 2007
Pages: 18 p.
Abstract: Mobile health units (MHUs) are often used to provide health care in unstable situations, such as armed conflicts, where fixed services cannot function for reasons of security. They are, however, a controversial way of providing health care, because of their cost, their irregular service provision and their logistical complexities. Drawing on the experience of the International Committee of the Red Cross (ICRC) and on the relevant literature, this network paper provides a decision-making framework for health care workers considering whether to use MHUs. The paper gives an overview of the place of MHUs in a health care system, and provides the theoretical background to the decision-making process around how and when to set them upages. It also elaborates on the strengths and weaknesses of MHUs.
Title: Non-structural vulnerability assessment of hospitals in Nepal
Author(s): By the National Society for Earthquake Technology (NSET) Nepal, World Health Organization (WHO), the Epidemiology and Disease Control Division (EDCD), Ministry of Health, Department of Health Services, Nepal
Source: NSET, 2003
Pages: 84 p.
Abstract: Section 1 of this report presents the introduction of the study project and section 2 the objective, scope and approach while section 3 includes the methodology. The result on hospitals performance assessment and recommendations to improve seismic performance has been given in section 4. Section 5 presents examples of mitigating non-structural vulnerability of hospitals.
Title: Practical guidelines for infection control in health care facilities
Author(s): By the World Health Organization (WHO)
Source: WHO, 2004
Pages: 103 p.
Abstract: These guidelines, jointly prepared by the WHO Regional Offices for South-East Asia and the Western Pacific, should help countries to strengthen their infection control practices in health care facilities. This would help to prevent further spread of infection and to deal effectively with new infectious diseases like SARS as well as other hospital-associated infections. The guidelines address all aspects of an infection control programme with special attention being paid to SARS. Since information on SARS is still evolving, these guidelines will be updated as more specific information becomes available.
Title: Prehospital and disaster medicine: disaster terminology
Author(s): By Domres Debacker, Walter Hays de Boer
Source: Glossary of New Concepts in Disaster Medicine, 2002
Pages: 28 p.
Abstract: The terms in this glossary are an alphabetical compilation of definitions from the "Health Disaster Management Guidelines for Evaluation and Research in the 'Utstein-Style'" that aims to develop a structural framework for investigations into the medical and public health aspects of disasters that could be used as for the appropriate design, conduct, and reporting of evaluation and research, those provided by Walter Hays, and Debacker, Domres, and de Boer's "Glossary of New Concepts in Disaster Medicine". They are in addition to those selected from the current volume of Gunn's Multilingual Dictionary of Disaster Medicine and International Relief.
Title: Principles of disaster mitigation in health facilities
Author(s): By the Pan American Health Organization (PAHO)
Source: PAHO, 2000
Pages: 123 p.
Abstract: This book is an updated compilation of various documents on the topic already published by PAHO/WHO. Sections of previous publications have been revised to address the needs of professionals from a variety of disciplines, particularly those involved in health facility planning, operation and maintenance. It does not attempt to address the more technical and specialized aspects of disaster mitigation. Figures and photographs illustrate situations that can increase disaster vulnerability in health facilities. Examples are given of how countries in Latin America have conducted vulnerability assessments and applied specific disaster mitigation measures in their hospitals and health centers. The book focuses on problems encountered in areas at high risk for seismic events. It introduces the essential aspects of carrying out vulnerability assessments and applying practical measures to mitigate damage in hospitals, addressing structural and nonstructural aspects, as well as administrative and internal organization.
Title: Protecting new health facilities from natural disasters: guidelines for the promotion of disaster mitigation
Author(s): By the Pan American Health Organization (PAHO), World Bank, World Health Organization (WHO), ProVention Consortium
Source: PAHO, 2003
Pages: 52 p.
Abstract: Hurricanes, floods, earthquakes, landslide and volcanic eruptions - and the devastation they inflict - are all too familiar to the countries of Latin America and the Carribean. In the last decade, natural disasters have caused more than 45,000 deaths in the region, left 40 million injured or in need of assistance, and carried a price tag - in direct damage alone - of more than US$20 billion.
Title: Rapid visual screening of buildings for potential seismic hazards: a handbook
Author(s): By the National Earthquake Hazards Reduction Program (NEHRP), Applied Technology Council (ATC), Federal Emergency Management Agency (FEMA)
Source: NEHRP, ATC, FEMA, 2002
Pages: 140 p.
Abstract: The procedure presented in this Handbook is meant to be the preliminary screening phase of a multi-phase procedure for identifying potentially hazardous buildings. Buildings identified by this procedure must be analyzed in more detail by an experienced seismic design professional. Because rapid visual screening is designed to be performed from the street, with interior inspection not always possible, hazardous details will not always be visible, and seismically hazardous buildings may not be identified as such. Conversely, buildings initially identified as potentially hazardous by RVS may prove to be adequate.
Title: Safe hospital checklist
Author(s): By the Pan American Health Organization (PAHO), World Health Organization (WHO)
Source: PAHO/WHO
Pages: 6 p.
Abstract: This checklist records elements relating to the geographic location of the health facility to be evaluated such as geological, hydro-meteorological, social, environmental sanitation, chemical and/or technological phenomena, and geotechnical properties of the soil; and structural safety of the building. Columns, beams, walls, floor slabs, etc., are structural elements that form part of the load-bearing system of the building. These elements should be evaluated by structural engineers.
Title: Safe hospitals, a collective responsibility, a global measure of disaster reduction
Author(s): By the Pan American Health Organization (PAHO), World Health Organization (WHO)
Source: PAHO/WHO, 2005
Pages: 31 p.
Abstract: Protecting critical health facilities, particularly hospitals, from the avoidable consequences of disasters, is not only essential to meeting the Millennium Development Goals set by the United Nations, but also a social and political necessity in its own right. This is the message that this publication, prepared by PAHO/WHO for the UN World Conference on Disaster Reduction, puts forth. The importance of hospitals goes far beyond the role they play in saving lives after disasters. They are powerful symbols of social progress and a prerequisite for economic development, and as such, special attention must be given to reducing their physical vulnerability.
Title: SB1953 and the challenge of hospital seismic safety in California
Author(s): By Charles Meade, Jonathan Kulick, RAND Corporation
Source: California HealthCare Foundation, 2007
Pages: 62 p.
Abstract: Funded by the California HealthCare Foundation, RAND has updated its analysis of the costs and policy issues surrounding implementation of California SB1953, the state law governing seismic safety for all acute care hospitals. Under the law's requirements, approximately 50% of California hospital buildings must be replaced or substantially strengthened by 2030. For this analysis, have been collected updated construction cost data, and comprehensive information on the status of hospital construction projects.
Title: 45th Directing Council, 56th Session of the regional committee: report on reducing the impact of disasters on health facilities
Author(s): By the Pan American Health Organization (PAHO), World Health Organization (WHO)
Source: PAHO/WHO, 2004
Pages: 7 p.
Abstract: This document invites Member States to assign priority to keeping hospitals functioning in the aftermath of major catastrophes. It also makes the case for ensuring that reducing the functional vulnerability of hospitals be designated a benchmark or indicator of success in global reduction programs and that this be reflected in the outcome of the United Nations World Conference on Disaster Reduction in early 2005. Given the limited resources available, the countries of Latin America and the Caribbean, and in particular the health sector, have been working proactively to develop efficient and effective strategies to face the loss of health assets in the wake of disasters. A number of strategies have been explored over the course of the last two decades and there has been a good deal of success, primarily on a pilot basis. Concretely, with current knowledge, existing resources, and a strong political commitment, it is possible to achieve visible results.