1. Hospitals Safe from Disasters: Elisaveta Stikova, Ronald LaPorte, Faina Linkov, Margaret Potter, David Piposzar, Sam Stebbins Reduce Risk, Protect Health Facilities, Save Lives

2. Learning Objectives To introduce student with UN/WHO joint campaign for disaster reduction and safe hospitals To enlighten the Hyogo Framework of Action and the 2008-2009 disaster reduction campaign To explain the role of WHO in joint activities to promote disaster reduction campaign To clarify the 10 goals of World Health Day 2009 enlighten in WHO tool kit

3. SEE Public Health Preparedness Supercourse Network Elisaveta-Jasna Stikova Present position 1991-Present, Professor, University “Ss. Cyril and Methodius”, Medical faculty, Skopje, Macedonia (courses taught: Occupational Health, Public Health, Medical Ecology, Hygiene 1994 – Present, Director and Advisor, National Public Health Institute, Skopje, Macedonia 2009 – Fulbright Visiting Scholar, Pittsburg University, Graduate School of Public Health – New Educational Pathway for Global Public Heath Security

4. SEE Public Health Preparedness Supercourse Network Co-Authors and collaborators: Ronald E. LaPorte, PhD, UPGSPH, Director, Disease Monitoring and Telecommunication, WHO Collaborating Center Faina Linkov, PhD, Assistant Professor, Cancer Institute Margaret Potter, JD, MS, Associate Dean and Director, UPGSPH, Center for Public Health Practice David Piposzar, MPH, UPGSPH, PPLI Co-director Sam Stebbins, MD, MPH, UPCPHP Principal Investigator/Director, Center for Public Health Preparedness

5. Hospitals Safe of Disasters The most costly hospital is the one that fails!!!

6. Hospital Safe from Disasters Disaster means that basic needs of people exceed the available recourses of community During disasters health facilities usually can’t serve to the needs of the population because of: Increasing of demands Decreasing of delivery capacities

7. World Health Day 2009 Hospitals Safe from Disasters: Reduce Risk Protect Health Facilities Save Lives Safety of facilities Readiness of health workers to respond to the needs

8. Hospitals Safe of Disasters Hyogo Framework for Action to reduce our collective vulnerability to natural hazards Disaster risk reduction is important action aims to achieve MDG Disaster risk reduction is everybody's business Only tangible measures can reduce vulnerability and protect development Ban Ki-Moon, UN Secretary-General

9. What is Hospitals Safe from Disaster Means? Safe hospitals is more than physical and functional integrity of the health facility Safe hospitals means to be prepared for functioning in full capacity, appropriate for the needs of the affected people, immediately after a hazard strike!!!

10. What is Hospitals Safe from Disaster Means? A safe hospital means that: It will not collapse in disasters It can continue to function and provide its services as a critical community facility when it is most needed It is organized, with contingency plans in place and health workforce trained to keep the network operational

11. What Are the Objectives of Hospitals Safe for Disaster Campaign? Three main objectives of campaign: Protect the lives of patients and health workers Make sure health facilities and health services are able to function Improve the risk reduction capacity including emergency management.

12. Why Focus on Hospitals Safe of Disasters? Algerian earthquake, 2003 – 50% destroyed health facilities Pakistan earthquake, 2005 - 49% destroyed health facilities Peru, Pasco earthquake, 2007 - within two minutes, the city lost 97% of its hospital beds to an 8.0 magnitude earthquake. China’s Wenchuan earthquake, 2008 – 11 000 health facilities (52%) were destroyed Viet Nam flood, 2008 – 61 hospitals were damaged provinces Fuji rains 2009 – flooded health facilities and devastate infrastructure

13. Hospitals Safe for Disaster 10 basic facts to know - 1 Many factors put hospitals and health facilities at risk: Buildings Patients Hospital beds Health workforce Equipment Services

14. Hospitals Safe for Disaster 10 basic facts to know - 2 Components of a safe hospitals or health facility: Structural elements Non-structural elements Functional elements

15. Hospitals Safe for Disaster 10 basic facts to know - 3 Hospitals would be put out of services during disaster because of: Structural damages Functional collapse

16. Hospitals Safe for Disaster 10 basic facts to know - 4 Hospitals and health facilities can be built to different levels of protection: Life safety Protect of infrastructure and equipment Operation protection

17. Hospitals Safe for Disaster 10 basic facts to know – 5, 6, 7 Making new hospitals and health facilities safe from disasters is not costly Field hospitals are not the best solution for damaged and destroyed hospitals Seeking the right expertise: a check consultant

18. Hospitals Safe for Disaster 10 basic facts to know - 8 Building codes are of utmost importance One of the earliest mentions of the importance of building codes is found in Hammurabi’s Code 2: “… [if the builder] did not construct properly this house which he built and it fell, he shall re-erect the house from his own means.”

19. Hospitals Safe for Disaster 10 basic facts to know - 9 Creating safe hospitals means shearing responsibilities Governments Health institutions and health workforce UN, international and local agencies and NGOs Donor community Financial institutions University, schools and professional institutions

20. Hospitals Safe for Disaster 10 basic facts to know - 10 The most costly hospital is the one that fails!

21. Hospital Safety Index Applicable tool for ranking of level of safety for each health facility/hospital Structural components Non-structural components Organizational/functional components

22. Cost effectiveness of prevention Building disaster safe hospitals is much cheaper in comparison of the consequences of destruction during disaster Almost 50% of health facilities were destroyed during the recent disasters Indirect cost of damaged health infrastructure can be higher than direct cost of replacement and rebuilding The cost of the disaster safe hospital is only 4% added to the cost of the new facilities

23. Hospitals Safe of Disasters The role of Universities, Schools and Professional institutions Develop professional curricula, modules or courses that contribute to hospital safety Act as repositories of specialized expertise Publish articles for scientific and technical publications and journals Contribute to the development and periodic review of national building standards

24. Hospital Safe of Disasters Safe Hospital Strategy: Strategic partnership Risk reduction in health sector Training and education Develop tools and guidelines Advocacy and awareness

25. Hospital safe of Disasters Target Audience Policy and decision makers, including in financial and planning sectors Professional associations/unions (engineers, architects, administrators) Hospital associations The public, directly and through the mass media Private and public managers of health systems Health professionals worldwide