Summary

WHY A CONFERENCE ON DISASTER MITIGATION?

Since 1960 natural disasters in Latin America and the Caribbean have caused the death of more than 180,000 persons and approximately US$ 54 trillion in property damages. The health sector has been particularly hard hit—hundreds have lost their lives when hospitals and health centers have collapsed in the most serious events, and health services interrupted when most needed.

As many as 50% of the more than 15,000 hospitals existing in the Region may he at high risk to natural disasters. A considerable number of these health facilities lack disaster mitigation programs, emergency plans, or the appropriate infrastructure for resisting powerful earthquakes and hurricanes.

This need not he the case. Health facilities can take measures to reduce the structural impact of natural disasters. The additional cost of building hospitals to seismic and wind resistance standards is minimal, making the failure to enforce such standards inexcusable. Providing structural reinforcement in existing facilities is, however, much more costly.

Interventions to reduce nonstructural vulnerability—protecting equipment and medical supplies or ensuring the integrity of lifeline services, for example-can he carried out to a large extent by staff of the health facility with minimal capital investment.

WHO ATTENDED?

More than 500 representatives from governments; international, regional, and nongovernmental organizations; and the private sector of the Latin American and Caribbean countries met in Mexico City from 26 to 28 February at the International Conference on Disaster Mitigation in Health Facilities. The Conference was convened by the Pan American Health Organization, Regional Office for the Americas of the World Health Organization (PAHO/WHO), together with Mexico's Ministry of Health, Ministry of the Interior, and Social Security Institute the Secretariat of the International Decade for Natural Disaster Reduction (IDNDR) of the UN Department of Humanitarian Affairs (UN/DHA); the Economic Commission for Latin America and the Caribbean (ECLAC); the General Secretariat of the Organization of American States (OAS); and the World Bank.

The Government of Mexico hosted the Conference at the XXI Century National Medical Center in Mexico City. Several of the hospitals that form part of this complex were seriously damaged in the 1985 earthquake and have since been rebuilt or retrofitted. This mural commemorates the lives lost and heroic measures taken by the Center's medical staff and rescue workers in the aftermath of the disaster. (Photo: H. Molin, PAHO/WHO)

WHAT WAS DISCUSSED?

Presentations on disaster impact, vulnerability analysis, and mitigation strategies for health facilities included studies from Chile, Colombia, Costa Rica, Eastern Caribbean Islands! Ecuador, Jamaica, and Mexico. Government delegations presented progress reports on disaster mitigation objectives and practices in their national facilities. Technical Commissions met to discuss specific disaster mitigation strategies for earthquakes and hurricanes.

A highlight of the Conference and an expression of Mexico's commitment to ensuring that their hospitals withstand natural disasters, was the agreement signed by the Minister of Health of Mexico, Dr. Juan Ramón de la Fuente, and Dr. George Alleyne, Director of PAHO, whereby national and international committees will recognize the efforts and achievements made by national hospitals toward realizing safety standards.

OUTCOME

Conference participants approved "Recommendations and Goals," urging Governments and regional and international organizations to adopt policies to reduce the vulnerability of existing and planned hospitals to hurricanes and earthquakes. They also defined mitigation strategies in the design, construction, retrofitting, and maintenance of health facilities. These strategies will he presented for consideration to the political and technical decision-making levels of the health sector, trilateral and multilateral financing agencies, development planning organizations, professional schools, and other sectors, private as well as public.

A five-year plan for initiating or strengthening the disaster mitigation process in hospitals in each country was recommended. To the degree allowed by local political, economic, and organizational conditions, it was recommended that by the sear 2001 all "priority" hospital structures he able to withstand moderate- to high-intensity events without suffering functional damage and without danger of collapse. It was also recommended that the level of vulnerability to natural hazards and the level of preparedness be criteria for accrediting hospitals.

Arguably the most important result of the Conference was the personal commitment developed or strengthened among the participants to promote disaster mitigation strategies in new constructions and retrofitting projects. Participants requested PAHO to continue its disaster mitigation program in the areas of promotion, training, and regular evaluation of achievements in countries and territories of Latin America and the Caribbean.

Documents and case studies presented during the Conference may be requested, in Spanish or English, from the Regional Disaster Documentation Center, P.O. Box 3745-1000, San José, Costa Rica; Tel: (506) 257 2141; Fax: (506) 257 2139. They can also he viewed via the Internet: gopher://gopher.paho.org or http://www.paho.org/english/disaster.htm.