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close this bookDisaster Mitigation for Health Facilities: Guidelines for Vulnerability Appraisal and Reduction in the Caribbean (PAHO-OPS, 2000, 66 p.)
View the document(introduction...)
View the documentIntroduction
View the document1. What is Mitigation?
View the document2. Role of Health Staff
View the document3. Using the Guide
Open this folder and view contentsAnnexes
View the documentBibliography
View the documentBack Cover

1. What is Mitigation?

During the last 15 years, it is estimated that over 90 hospitals and over 500 health centres in Latin America and the Caribbean have been damaged by natural hazards. These have been documented in more detail in other publications (see Bibliography) but probably the most serious both in terms of loss of life and injury and impact on the health services was the 1985 earthquake in Mexico City. This event affected three of the largest hospitals in the city, resulting in the loss of 856 lives and 5,829 beds.

The impact a hazard has on inadequately designed and constructed facilities can lead to disasters.

A disaster therefore, is an event that occurs usually unexpectedly and suddenly causing severe hardship to people or things, sometimes resulting in the destruction of property, damage to the environment and possibly injury and loss of life.

A paediatric ward was made roofless during a hurricane because of the inadequate strength of rafters and their connections. (Photo Tony Gibbs)

Examples of natural hazards are:

Volcanic eruptions
Tsunamis (tidal waves/storm surges)
Landslides (some)
Torrential rains/floods (some)

In addition, there are “slow onset” disasters such as droughts and epidemics and also “Man-made” disasters such as fires, explosions, contamination etc. All have relevance and have to be taken into account as we look at our health facilities.

What has also been demonstrated, particularly in relation to hurricanes, is that relatively low cost retrofitting can protect buildings and equipment, thus allowing facilities to remain functional, and in some cases these measures can save lives,

The equipment in an intensive-care unit should be secured against toppling and sliding during earthquakes. (Photo PAHO)

Mitigation can be defined as the reduction or prevention of damage that a hazard may cause. It refers specifically to preventive activities pre-event, compared with response in the immediate aftermath, and rehabilitation in the medium to long term. Specifically in relation to health facilities the objectives of mitigation are:

To protect the public (patients, visitors etc.) and staff from injury or death

To enable critical departments to remain functional during and immediately after an event.