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These
disasters also profoundly affected health facilities
and the communities that depend on them. All health
facilities, big or small, whether a primary health centre
or a district hospital or a specialty referral centre,
are in the frontline during an emergency. Health facilities
are at risk from natural or human-generated hazards.
In recent times, health facilities have also been targets
of man-made violence. These facilities and the structures
that support them need to be strengthened so that they
continue to provide the needed services to the injured.
But what makes a health facility safe? There are three
aspects: structural, nonstructural and functional.
1.
Modern engineering and architectural science and design
have already provided us with low-cost solutions for
ensuring structural integrity, so that health facilities
do not collapse during earthquakes or cyclones.
2.
In some cases we have seen that although a health facility
remains intact, it is rendered non-functional. Lifelines
such as water and electricity must be backed up, equipment
well secured and access and escape routes ensured.
3.
Organizational aspects also play a role. A safe health
facility has contingency plans and a well-trained health
workforce that is ready and able to deal with the health
consequences of emergencies.
Our
Region has taken important steps to make health facilities
safe in disasters and save lives. The 12 South-East
Asia Region Benchmarks for Emergency Preparedness included
the issue of safe health facilities. It is a complete
set of standards, indicators, and checklists to guide
Member States and institutions in improving existing
health facilities and ensuring that new ones are built
to withstand disasters. WHO is committed to supporting
countries in achieving this benchmark. The Safe Hospitals
Index developed by WHO/PAHO is another tool that can
be applied. From Nepal and Indonesia more nationally
adapted tools have been produced to measure the safety
of health facilities so that decision-makers can prioritize
actions.
The
most significant effort we have seen on this issue is
structural and nonstructural vulnerability assessments
of hospitals and blood banks in the Kathmandu Valley,
Nepal, conducted by WHO in partnership with the Ministry
of Health and the National Society for Earthquake Technology,
Nepal. Global scenarios are changing. Our own development
is pushing our health facilities to their limits. Rapid
urbanization and migration are themselves looming emergencies
for the environment and its inhabitants; climate change,
where there is no predictable scenario, will also require
health facilities to perform during extreme weather
events. For all these reasons it is vital that we discuss
the safety of hospitals not only within the health sector
but also outside it.
Thus,
other sectors and players have to be involved. And,
as community members, we need to be fully aware of the
issues, and be strong advocates to create the necessary
awareness among decision-makers. Financial institutions
should also lend a hand in ensuring that the infrastructure
projects they support are disaster-resilient, including
health facilities. I hope that this year’s World
Health Day will help to highlight that health concerns
should be the primary motivation behind any action to
reduce disaster risks. It is, therefore, all the more
important for the health sector to play a pivotal role
in catalysing disaster reduction at the local, national
and international levels. Let us remember that safe
health facilities mean lives saved.
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