|Mitigation of Disasters in Health Facilities: Volume 3: Architectural Issues (PAHO, 1993, 80 pages)|
|Chapter 3: Mitigation measures in hospital design|
|Functional analysis of hospital sectors|
The preceding chapter indicated the areas making up a hospital and also referred to the need for making certain design variations that would help to mitigate disasters in the building (Figure 12).
It is considered essential, not only for the purpose of disaster mitigation and prevention but also for the administration of the building, that the possibility be explored of separating the General Services sector
from the main block of the hospital building (Figure 13). Following are reasons for taking this architectural design measure: a. The boiler area is usually located in the General Services sector, which in most cases becomes a dangerous time bomb that can produce untold disaster if an explosion occurs.
If the boilers are located outside of the main building, the damages to the general infrastructure would be mild in the event of an explosion and would affect the hospital's operation to a lesser degree. This is also the case of the hospital's gas plant. Although it is true that building a separate structure for these services would increase the initial costs of construction, the increase would be of little consequence compared with the cost of the damages ensuing from an explosion.
b. Another service that is commonly located in the General Services sector is the emergency plant. This service could also be located separately, not so much because of the inherent risks it involves as for the advantage offered by its possible use during critical moments.
If located outside the main building, this plant, in the event of fire or earthquake, could be used to carry out many activities, either outdoors or in sectors of the building that have not been affected. Since the substation and the control panels are located together with the emergency generator, this entire energy complex would be located in the proposed independent structure, whose seismic-resistance specifications would be much stricter in order to ensure its operation even in the event of an intense earthquake.
c. For the same reasons it is considered desirable to locate telephone, radiocommunications, and similar services in this sector, since as in the case of the energy system, they may be used in the event of a disaster situation.
As mentioned previously, it also is desirable, whenever possible, to locate hospital water storage tanks in this area. Since they are most commonly located on the upper floors of the building, they represent additional loading on the structure and thus increased risk. If these services are located in the independent structure proposed for the general services sector, they would not only reduce the lateral loads on the main building in the event of earthquake, but also make it possible to ensure permanent and continuous water supply during the postdisaster period. With a guaranteed electric power supply, water-pumping equipment would remain in operation, thereby making it possible to supply the building and the fire-fighting system, constituting one more element for the mitigation and prevention of disasters.
d. It would also be desirable to locate the kitchen services within the proposed independent structure, where they would be provided with water, electric power, and gas services. Food supply could be available not only for the usable sectors of the hospital building but also for the adapted areas in the open areas. Something similar would occur with the laundry service, which would complete the package of facilities available to serve either partially or totally the areas of the hospital affected by the event or a possible field hospital.
It should be noted that the foregoing is possible if an entire multidisciplinary team is available in which engineers, architects, and planners as well as medical and paramedical personnel, participate in making general proposals for actions, responsibilities, movements, and physical solutions to implement the above recommendation.
This new area or sector of the hospital may be likened to a kind of bunker that houses vital equipment - similar to an intensive care unit - that would be designed to supply and control communications and water, gas, and electrical power to serve either partial or full operation of the hospital or even, in an extreme case, a field hospital (Figure 14).