|Mitigation of Disasters in Health Facilities: Volume 2: Administrative Issues (PAHO-OPS, 1993, 74 p.)|
|Chapter 4: Vulnerability of hospitals|
It is easy to conclude that hospitals have more problems being prepared for a disaster than any other service. Many of the problems mentioned previously stem from deficiencies in the structural and nonstructural safety of the building. In the case of a new building, the structural component should be considered during the design and construction stage, or in the case of an existing building, during repair, remodeling or maintenance. A good structural design is crucial if the building is to withstand a severe earthquake. The building may be damaged, but it is unlikely to collapse. If a hospital collapses even partially, it will be a liability for the community after the disaster and not the asset that it should be.
Moreover, in the planning of a hospital it is necessary to take into account that one of the most common causes of damage in buildings is a hazardous architectural-structural configuration. Departure from simple structural schemes can turn out to be a costly decision when it comes to earthquakes. In addition, unfortunately, the usual methods of seismic analysis fail to quantify most of these problems correctly. Given the erratic nature of earthquakes, as well as the possibility that their magnitude will exceed that envisaged in a building's design, it is advisable to avoid proposing hazardous configurations, regardless of the degree of sophistication that it may be possible to achieve in the analysis of each particular case.
Unfortunately, in many countries of Latin America seismic-resistant construction standards have not been effectively applied and in others such standards have not taken into account specifications unique to hospitals. Thus, it is hardly surprising that every time that an earthquake occurs in the region the buildings worst hit are precisely the hospitals, which should be the last to be affected. Because the structural vulnerability of hospitals is in general high, this situation should be corrected totally or partially if enormous economic and social losses are to be avoided, especially in developing countries.