3.2. Health sector reconstruction planning

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SafeWorldBook Box3 7 IconAs shown in previous chapters, the effects of disasters vary. For example, in the case of an earthquake, the impact on the community can be so great that the capacity to provide health services is sharply reduced for a long time afterward. Floods, not only impact the land and the production sector but also cause serious damage health infrastructure and hospital equipment, which often causes the functional collapse of health facilities, as this article on understanding critical infrastructure failure in the wake of Hurricane Katrina illustrates.

The reconstruction period offers both challenges and opportunities in the aftermath of disasters.

With regard to health facilities, reconstruction offers the opportunity to make both structural and organizational changes that reduce future vulnerability of health infrastructure and increase the effectiveness of services. Reconstruction in the health sector should take into account some of the following issues:

  • An analysis of the level of risk to which the area affected by the disaster is exposed (see Module 3 in this Portal) and its subsequent vulnerability to possible future events, better decisions can be made regarding whether to rebuild the damaged infrastructure in the same place or select an alternate site that is safer.
  • The reconstruction phase offers an excellent opportunity to make changes in the health services network and care model by avoiding construction of very complex hospitals or hospitals with a large number of beds. During the reconstruction process, consider the primary-care-based model, which facilitates response capacity at the primary care level and promotes an appropriately designed hospital network based on the principles of referral and counter-referral.
  • The concept and principles of the ‘safe hospitals’ initiative should be rigorously applied when building new health facilities. Ensuring that hospitals and all levels of health facilities meet structural, nonstructural, and organizational safety requirements is the responsibility of national health authorities, with input from the technical specialist in charge of the Health Emergencies program.
  • The reconstruction phase is also an opportunity to strengthen disaster preparedness and mitigation procedures and activities in the health sector (see Modules 3 and 4). Risk prevention and reduction should be a ubiquitous part of reconstruction projects in the sector.
  • Take new developments in technology into account to strengthen architectural standards for new architecture and equipment and/or update existing buildings and equipment.
  • Develop or update accreditation procedures to incorporate the safe hospitals initiative in disaster situations.