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Guidelines for vulnerability reduction in the design of new health facilities

Book of Stress Management In DisastersIt is almost always the case that, 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.

In recent years, various PAHO/WHO member states have managed to reduce the vulnerability of their hospitals; several of them withstood the effects of subsequent disasters. Even countries with limited financial resources can serve their populations well by providing them with hospitals and other health facilities that are resistant to earthquakes, hurricanes, and other natural hazards.

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

PAHO/WHO recommends that essential areas and components of hospitals be built to keep the third and most demanding performance objective, and that new health facilities be built entirely so as to meet, at least, the first level of protection, namely life safety.

International experience has shown that applying this philosophy to the construction of a new hospital, only adds about 4 percent to the total cost of the project. This is the maximum amount that hospital authorities, project designers, builders and financial agents must weigh against the social, political and economic costs arising from the interruption or total loss of vital services at the very time that they are most needed. By contrast, applying innovative approaches when designing and selecting the site of a new facility can improve its safety and efficiency without significantly increasing overall costs.

This publication seeks to spread far this 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.

This book can be ordered from PAHO's Emergency Preparedness Program (disaster-publications@paho.org), or can be downloaded, by chapters, as PDF files. You need to have installed Adobe Acrobat Reader to read these files. It can be obtained free of charge from the Adobe Website.