6. Protecting health services infrastructure

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6 proteccion de infraAll new hospitals should be built with a level of protection that ensures that they can continue to operate in disaster situations. Existing facilities, particularly those that provide primary and emergency care, should implement adequate mitigation measures. This requires timely action regarding all new investments in the health area.

Protecting new health facilities from disasters

In a country with a moderate to high frequency of natural disasters, risk management should be incorporated in the initial phase of discussions and political negotiations with funding sources for construction of new health facilities, as well as in the planning, design, and construction of these facilities. Not only will this have a positive social impact, but also a positive cost-benefit, since it protects capital investment and makes development more sustainable.

 

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6.1. Planning

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planificacionCurrent technological advances and changes in design philosophy and quality assurance standards for construction and infrastructure maintenance make it possible to mitigate damage from natural hazards. However, technical, economic, and political/social limitations make it impossible to reach high levels of protection for all situations.

Therefore, taking into account the characteristics of the health services network, the population’s epidemiological profile, and the available economic resources, it is possible to determine which facilities have a high level of operational safety, and which have well-protected infrastructure (although the latter may not be able to function immediately after an emergency, they can recover within a reasonable timeframe and with controlled costs).

 

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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.

 

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6.3. Structural design

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diseno no estructuralAfter the proper site is selected, the next important step is to develop an infrastructure design that provides a level of safety consistent with the protection goal set for the facility. The protection systems being considered should be realistic and lend themselves to effective maintenance.

 

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6.4. Nonstructural design

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"Elements that are not a part of the system that supports the building are considered nonstructural elements”

6 4 diseno noestructural

Non-structural design looks at essential systems such as (but not limited to) electrical, hydraulic, sanitation, heating, ventilation, and air conditioning systems; furniture and fixed or movable office equipment, as well as medical and laboratory equipment; supplies used for diagnosis and treatment; and some architectural elements of the building. Consult parts 2 and 3 of the Safe Hospitals Checklist for what to look for in the way structural and nonstructural elements.

 

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6.5. Medical-architectural design

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6 5 diseno medico arquiHospital design considerations include specifications to improve their performance during and in the immediate aftermath of seismic, flooding, and high-wind events.

The most common medical-architectural schemes used in the design of hospitals do not cover functional issues that arise in disasters, such as an increase in the number of hospitalized patients, the special care required by patients dependent on life support systems, and the setting up or restriction of spaces for handling the emergency or to conserve resources.

 

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