Dr. Mirta Roses Periago*
April 7, 2009.
World Health Day 2009.

Earthquakes, hurricanes, volcanic eruptions, floods, and other natural phenomena frequently ravage our Region, with every year bringing an average of 130 disasters of varying magnitude. When a disaster strikes, our most immediate concern is to save lives, help the injured, and restore well-being to the affected communities.

This cannot be accomplished without a vital element: our hospitals. However, more than half of them--that is, over 8,000 in Latin America and the Caribbean, are located in high-risk areas. If these health facilities cease their operations because of a disaster, the repercussions will be infinitely worse. This year, therefore, World Health Day underscored the need for safe hospitals.

Safe hospitals are facilities where services remain accessible and that operate at full capacity in their own infrastructure immediately following a disaster. To ensure this, they must have the maximum protection possible, access routes to them must remain open, and drinking water, electricity, and telecommunications services must keep operating. All this will guarantee the continuous operation of hospitals and enable them to absorb the additional demand for medical care.

Building safe hospitals is feasible from both a technical and an economic standpoint. In fact, studies show that if the recommended measures for mitigating the risks of natural disasters are integrated into the planning and design stages of a new hospital, the cost of building and equipping a safe hospital is practically the same as for a vulnerable hospital. In contrast, according to a study by ECLAC, an unsafe hospital generates millions of dollars in losses in infrastructure, equipment, and materials when the hospital is damaged during a natural disaster, as well as indirect economic and high human and health costs.

The safe hospital strategy advocated by the Pan American Health Organization calls for all new hospitals to be built in compliance with safety standards. Countries such as Ecuador, Mexico, and Peru have created national safe hospital programs, and Central America is working on an ambitious plan to implement this initiative in Costa Rica, El Salvador, Honduras, Nicaragua, and Panama. In the Caribbean, countries such as Barbados, Cuba, Dominica, Jamaica, Grenada, Saint Kitts and Nevis, Saint Vincent and the Grenadines, and Trinidad and Tobago are using the Hospital Safety Index, created to evaluate safety levels in 145 different areas. Bolivia and Paraguay also have been working on this regard.

Moreover, specific measures are urgently needed to increase the safety of existing health facilities. Chile, Colombia, Costa Rica, Ecuador, the Cayman Islands, Mexico, and Peru have been successful in this regard. The costs are higher, but they are always lower than the tremendous losses that disasters inflict on facilities that have not been reinforced.

In reducing hospital vulnerability to natural disasters, humanitarian and public health considerations should be first and foremost, although reducing vulnerability in itself is an excellent investment. The decisionmakers responsible for public investments that affect the community should bear in mind that citizens are very conscious of the key message of World Health Day 2009: "When Disaster Strikes, Safe Hospitals Save Lives."

* Director of the Pan American Health Organization

Article from the Director of the Pan American Health Organization published in several communications media in the region during the celebration of the World Health Day 2009, theme: "When Disaster Strikes: Safe Hospitals Save Lives".

Media Publication:
Guatemala, Diario El Periódico: Hospitales seguros y desastres [04/25/2009]
Costa Rica, Cámara Nacional de Radio: Hospitales seguros y desastres [04/24/2009]
Barbados, The Barbados Advocate: Safe Hospitals and Disasters [04/21/2009]
Costa Rica, Diario Extra: Hospitales seguros y desastres [04/15/2009]
Caribbean Net News: Safe hospitals and disasters [04/11/2009]
Bolivia, La Razón: Hospitales seguros y desastres [04/10/2009]
República Dominicana, Clave Digital: Gente y Salud. Hospitales seguros y desastres [04/9/2009]
Nicaragua, La Prensa: Únase para hacer hospitales seguros ante desastres [07/07/2009]