Introduction

The planning, design, and construction of hospitals in areas prone to natural hazards pose many challenges to the various professionals involved not only because of the hospitals' importance in normal city life but also because of the importance they assume if the victims of a disaster must be cared for. Given the significance of hospitals for the recovery of an affected community, for example in the event of a strong earthquake, careful consideration should be given to a wide range of factors, from planning disaster response to installing equipment and various non-structural equipment and elements, in addition to the requirements of structural resistance and safety.

Despite the foregoing, many hospitals have suffered serious damage or have undergone functional or structural collapse as a result of disasters, in particular in the case of intense earthquakes, thus depriving the respective communities of adequate care for victims.

There is a need to review existing standards for the design and construction of hospitals, orienting them towards the mitigation of disasters, and the possibility of suggesting a series of changes in hospital infrastructure, from conception through to the actual construction and operation of the building.

This document aims to present a series of considerations on the criteria governing architectural design of health infrastructure and offers recommendations that should be discussed by participants representing various disciplines on ways to mitigate risk both to the population and to the investment made in construction of health facilities.

Chapter 1 of this manual examines briefly the concepts relating to the characteristics of disasters, in particular seismic hazard. Chapter 2 deals with general considerations relative to the architectural design of hospital buildings. It reviews the criteria governing design, emphasizing the necessity for teamwork among professionals from a myriad of disciplines if a coordinated approach to meeting the needs of the infrastructure is to be achieved.

Chapter 3 discusses design changes that can be considered for disaster mitigation. By making adjustments in their design standards, new as well as existing hospitals can adapt their traditional schemes to come up with solutions that from a physical-functional standpoint enable them to better respond in times of disaster.

Chapter 4 analyzes the factors that make hospital buildings vulnerable. It discusses the problems of functional vulnerability that could lead to the collapse of hospital service after a sudden-impact event, and to potential damage of facilities, equipment, and non-structural elements.

Chapter 5 deals with how to assess vulnerability conditions. It discusses how to carry out inspections and make inventories of non-structural elements and how to reduce or mitigate risk to hospital buildings, equipment and finishings.

Finally, Chapter 6 addresses professional training in the specific area of architectural design of hospital facilities. It suggests curriculum adaptations and continuing education courses to promote these nontraditional features in the training of architectural designers and builders.