6.2. Choosing a safe site

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Chapter 3 of the Guidelines for vulnerability reduction in the design of new health care facilities provides the information needed to define hazards. The main reason for the collapse of health infrastructure and the resulting fatalities is that hospitals are built without taking account of natural hazards. Also, systems deteriorate over time if not properly maintained.

The minimum background information required to characterize the site of a health includes: location and access; supply and quality of essential services; urban planning factors; common risks and natural and technological hazards; topographical and geotechnical information; and legal and economic factors.

Risk maps can provide valuable information when making decisions about appropriate sites in light of natural hazards; land management maps and local or regional development plans; technical reports; standards and regulations; and expert opinions. In addition, on-site inspections of each alternative site and its surroundings should be conducted. If the health facility is to be designed for a high level of security in a natural disaster scenario, detailed studies should be conducted in light of the particular hazards involved.

The selection of a location should also take into account the protection goals defined for the facility, both under normal conditions and in an emergency. It should include a comparative analysis of the natural and technological hazards at each site sites, should consider the estimated cost and technical feasibility of implementing the necessary protection systems, should take into account the availability of financial resources into account, and should examine the conclusions of cost/benefit analysis of the alternatives.

The analysis should cover not only the site of the facility, but the surrounding area. Consideration must be given to how natural phenomena affect the surrounding population and reference population, and how they affect infrastructureā€”in particular, the essential services and channels of communications that a health facility needs to fulfill its function. Special attention should be given to the proximity of industrial facilities (chemical plants, refineries, facilities that process mining products, etc.), military installations, sanitary landfills, airports, routes used to transport hazardous materials, etc., and, generally speaking, installations that as a result of their function, their potential to emit toxic substances, or the possibility of accidents in normal or emergency conditions, could affect the safety of the proposed new facility.

Once the existing background information has been collected, the alternatives should be evaluated. This requires a multidisciplinary team of experts to quantify risk according to the hazards identified. For each hazard, the technical and economic feasibility of setting up systems for the overall protection of the structure should be assessed as well as the possible impact on the population served, the availability of vital services, connected entities, and access to health services.