]]Lao People’s Democratic Republic: ]]Fiji: New and Impending Challenges ]]Cambodia: Revitalizing Health Centres ]]Nonga General

entres ]]Nonga General Hospital, Papua New

Enhancing Emergency Management for
the Health Sector, p. 2
]]Malaysia: Communication is Vital to
Ensure Hospitals are Safe from Disasters,
Re-emphasize need for Support for Safe by Learning from Past Experiences, p. 5 Guinea: A Call for Policies to Ensure Safe
Hospitals, p. 4 Hospitals, p. 7
]]Philippines: A Safe Hospital Surviving
]]Philippines: Safe Hospitals Start with A Major Typhoon, p. 6 ]]Viewpoint: Are YOU prepared for
p. 3 Safe Buildings, p. 4 Hospital Disasters? p. 8

Save Lives!
Make Hospitals Safe in Emergencies.

RECAP
Regional emergency collaboration, action and preparedness

EMERGENCY and HUMANITARIAN ACTION Special Issue | World Health Day 2009

Hyogo, Japan
A Model Approach to Disaster Risk Reduction
In the early morning of telecommunications, electrical Other advances were the The Hyogo Emergency
17 January 1995, a magnitude supply, as well as shortage renewal of the Emergency Medical Center (HEMC) was
7.3 earthquake struck the of medical manpower and Medical Information System established as the main DMC
Hyogo prefecture in Japan. damage to equipment led (EMIS), establishment of a in Hyogo in August 2003. As
Known hence as the Great to an overwhelming failure Disaster Medical Assistance of January 2008, there were
Hanshin-Awaji Earthquake of hospitals and health care Team (DMAT), education and 15 DMCs in Hyogo. Sitting at
or the Kobe Earthquake, the delivery services. training of medical staff on the core of the disaster health
quake affected 1.7 million The earthquake exposed disaster medicine, amendment management system, these
people in its immediate the vulnerabilities and of the National/Local centres have the capacity to
aftermath and left 6533 dead limitations of the existing Disaster Response Plan and, provide health services non-
and 43 792 injured. More disaster response and mutual cooperation among stop, utilize the EMIS, support
than half a million homes preparedness efforts of neighbouring fire departments.  continued on page 2

were damaged the Region.

Loss of water supply,
or destroyed, Recognizing Viewpoint
telecommunications,
and evacuees
electrical supply, as well
that safety From Quality Patient Care to Patient
numbered and security in
more than
as shortage of medical
communities is
Safety to Safe Hospital
manpower and damage
300 000. Direct the foundation of
to equipment led to an The battle cry of hospitals has always
damages progress, Hyogo
overwhelming failure of been, “We provide quality patient care!
amounted to formulated
hospitals and health care We have state-of-the art modern
about 50% of and adopted a
delivery services. sophisticated medical equipment. We
the prefecture’s comprehensive
have very competent physicians!” I
GDP. approach to disaster
have yet to hear hospitals with slogans
Hospitals were not prevention and reduction,
of, “We provide safe patient care! We
spared the devastation. Of as part of their “creative
are a safe hospital to go to even during
the 180 hospital buildings reconstruction” efforts.
times of emergencies and disasters.”
in the affected area, 45% Central to this approach was
The paradigm at present is still focused
required major repairs, 6.7% the designation of Disaster
on “quality” patient care with the
required rebuilding, and 2.2% Medical Centres (DMC),
assumption that quality encompasses
were completely destroyed. which will play the leading
 continued on page 3
Loss of water supply, role in disaster management.

page 1 EMERGENCY and HUMANITARIAN ACTION

 Lao People’s Democratic Republic
Enhancing Emergency Management for the Health Sector
The landlocked country of
the Lao People’s Democratic
Republic is sometimes seen as the
least affected by disasters when
compared to other Member States
in the Western Pacific Region.
Yet the rise of water levels in
the Mekong River last August
2008 revealed the importance
of preparedness and emergency
management in all situations.
Abundant rains in northern
Thailand, northern Lao People’s
Democratic Republic and north-
east Viet Nam last year resulted
to increases in water levels in the
Mekong River on 12-20 August
2008. The floods destroyed roads
and farmlands in 11 provinces,
affecting more than 200 000 people
(26 000 households) from 866
villages.
Health facilities were not
spared from the floods. Nineteen
health centres were flooded forcing
 Hyogo, Japan: A Model continued
a high patient load (including
long-distance transfers), treat
serious emergency cases (such
as multiple trauma), store
emergency relief goods and
materials, and train medical
staff in disaster medicine.
Doctors acting as Disaster
Medical Coordinators are
nominated for each centre. In
RECAP Regional emergency collaboration, action and preparedness
health staff to take emergency
actions and secure valuable medical
supplies and stocks. Health workers
who had previous training in
preparedness, contingency planning
and stockpiling and management of
drugs were able to apply their skills.
The quick action of the
government, the military and
concerned groups and individuals
to put up sand bags was effective
and reduced the drastic effects of
flooding, especially in Vientiane City
and other high-risk areas.
Prior to the floods last year,
the Ministry of Health of the Lao
People’s Democratic Republic
organized the first national-level
training course on Public Health
and Emergency Management in
Asia and the Pacific (PHEMAP). This
course was designed specifically
for emergency managers in order
to increase their level of awareness
and technical expertise by providing
addition to these functional
requirements, DMCs are
required to possess anti-
seismic structures and other
reinforcements to maintain
structural integrity in the face
of future disasters.
Fourteen years
after the Great Hanshin
Earthquake, due to the
massive reconstruction and
them with a holistic understanding
of the whole range of emergency
management.
This year, more PHEMAP
training courses are planned to
strengthen disaster preparedness,
management and response
capability among health personnel,
particularly among hospital staff.
Inclusion of safe health facilities in
the training will increase awareness
remodeling efforts, Hyogo
has already far exceeded
pre-disaster development
levels. It is clear that Hyogo,
has learnt a valuable lesson.
On the tenth year anniversary
of the disaster, Hyogo hosted
the World Conference on
Disaster Reduction during
which the Hyogo Framework
for Action (HFA) 2005-
2015, a blueprint to guide
disaster risk reduction efforts
worldwide, was drafted.
One HFA key activity is
‘’integrating disaster risk
reduction planning into the
health sector and promoting
the goal of hospitals safe
from disasters’’.
The experience of Hyogo
is an excellent paradigm for
the vulnerability of hospitals
to disasters, the impact of
hospital failure in disasters
and emergencies, and of the
need to approach disaster risk
among the health workforce,
ensuring that they will remain
functional during times of disasters
and emergencies.
Presented by Dr Sibounhom
Archkhawongs and Dr Phisith
Phoutsavath, Lao People’s
Democratic Republic Ministry of
Health during the Regional Meeting
on Safe Hospitals, 8-10 December
2008, Phnom Penh, Cambodia
reduction in a comprehensive,
multi-disciplinary manner.
The reconstruction of the
affected areas and the
remodeling of the disaster
health management system
highlighted the key roles
of health services, health
human resources, health
information systems,
and training in disaster
preparedness and response.
The creative reconstruction of
Hyogo received tremendous
legislative and financial
support, and sparked debates
on how to further increase
advocacy of stakeholders and
hospital administrators to
hospital safety.
Presented by Takashi Ukai,
MD, PhD, of the Hyogo Emergency
Medical Center, Humanitarian
Medical Assistance, during the
Regional Meeting on Safe Hospitals,
8-10 December 2008, Phnom Penh,
Cambodia
page 2
 Malaysia
Communication is Vital to Ensure Hospitals are Safe from Disasters
Malaysia’s topography and location
predispose the nation to a number
of natural hazards that may lead to
disasters. Not surprisingly, a good part
of its emergency and preparedness
programmes is geared
towards dealing with
typhoons and floods. The
peninsula is constantly in
the pathway of numerous
tropical storms, and over
the past four decades
Malaysia has suffered more than US$ 80
million in total estimated damages due
to floods.
Health facilities should remain
operational even in the face of disasters
to continue to provide for those affected, to functional status amounted to US$ 1.5
but at times nature proves to be too million.
overwhelming for these services. In 2004, Malaysia’s efforts are currently
the Kota Bharu hospital was unable to directed towards preventing repetitions
cope with rapidly rising water levels, of these said occurrences. Citing from
leading to flooding of its past events, “It is more expensive to
Health facilities some of its major sections learn from ‘bad’ experiences.” The nation
should remain operational and rendering them has recognized the need to strengthen
even in the face of nonfunctional. Torrential its disaster preparedness programmes
disasters to continue to rains in 2006 caused and has thus invested in mitigation and
provide for those affected major flooding in several disaster risk reduction. Risk analysis and
provinces, making health vulnerability assessment of all health
centres inaccessible. The floods affected facilities is currently under way in order
more than 500 relief centres, disrupting to identify those facilities in need of
much-needed medical services in areas hit reinforcement.
by typhoons. The financial cost for repair In its activities towards emergency
and restoration of these health facilities preparedness and  continued on page 7

 Viewpoint: From Quality Patient continued
safe patient care, that best effort
is enough in emergencies, and that
disasters rarely affect hospitals.
If I were a patient, I would ike
to be provided quality medical care,
one that is associated with a correct
diagnosis and accurate and effective
treatment with minimal side-effects.
I would also like to be provided with
a safe management regimen, one
that will NOT subject me to a high
risk for complications and death,
and not to say, medical
errors. Furthermore, I Making our
would like to be treated hospitals safe
in a safe hospital, one should also be
that will NOT collapse considered part
during earthquakes of our personal
which may occur when citizenry, our
I am in the hospital hospitals’ social
and one that will NOT responsibility.
burn me to death when
there is an accidental fire. I suppose
any human being, regardless of
position in the society, would want
the same things that I wish for in a
hospital.
All hospital managers will one
day most likely be a patient seeking
treatment in a hospital and wishing
the same things. As early as now, we
should start expanding and shifting
the paradigm to include patient
safety and safe hospital, not only for
our future and our family’s future,
but also for the sake of our client-
patients, the raison d’etre of our
hospital. Making our hospitals safe
should also be considered part of
our personal citizenry, our hospitals’
social responsibility. Making our
hospitals resilient in order to be able
to handle victims of mass casualty
incidents and prevent massive loss
of life and limb will contribute to
a faster post-disaster economic
recovery.
Being both a hospital
manager and a medical
practitioner in government
and private hospitals, I have
expanded quality patient
care to patient safety to
safe hospitals from 2003
to present. Thanks to the
campaign of the World
Health Organization’s global
alliances on patient safety and safe
hospitals which have opened my
eyes and which have facilitated this
expansion and shifting of paradigm.
On the disaster aspect, I started with
continual development of disaster
preparedness plans focusing on
response plans and drills on patient
surge, fire and earthquake. Lately, I
am now focusing on the structural
safety of the hospitals with which I
am connected.
In this early stage of my
experience with the safe hospital
campaign, in both private and
government hospital settings, I feel
there must be commitment and
full support from top management
to get the safe hospital initiative
implemented. In private hospital
settings, once there is commitment
and full support from top
management, resources needed
to fulfill the requirements for safe
hospital development are relatively
easier to procure than in government
hospital settings. In public
institutions, however, budgetary
constraints, administrative protocols
and organizational behaviour have
always been challenges. With lack of
financial resources, the structural and
non-structural requirements for a safe
hospital development are the hardest
to comply with. A well-organized
and collaborative emergency and
disaster committee is essential in
fulfilling the functional requirements
for a safe hospital development. No
matter what the constraints are in
a hospital setting, whether public
or private, as long as there is full
11 March 2009
Reynaldo O. Joson, MD
Assistant Medical Director, Manila Doctors Hospital
Chairperson, Department of Surgery, Ospital ng Maynila Medical Center
appreciation of the importance of
a safe hospital initiative by all staff,
full commitment and support of
the leaders, full cooperation and
collaboration of the staff, and a sense
of social responsibility, a safe hospital
can be developed, gradually and in
due time. One can start complying
with the functional requirements of a
safe hospital and placing mitigating
measures for the structural and non-
structural requirements if they cannot
be remedied at once.
Needless to say, safe hospital
development will reduce the
probability of a building collapsing
during a disaster and will allow the
hospital to continue to function
during emergencies. Safe hospitals
will avoid loss of properties, lives of
patients and staff, and increase its
surge capacity to function in times
of need. In short, hospital managers
should look at the benefits of the
safe hospital initiative in terms of
reducing risk, protecting health
facilities, and saving lives. I hope in
the near future I will be using and
seeing slogans like “Our hospital is
safe.”

page 3 EMERGENCY and HUMANITARIAN ACTION

 Fiji
New and Impending Challenges Re-emphasize Need for Support for
Safe Hospitals
The development of a and Central Divisions were South Pacific island countries (3) absence of analysis of
society, region or country closed due to floods. Water, such as Fiji are among the existing health facilities’ safety.
is closely intertwined with electricity and communication most vulnerable to the These recent floods serve as a
the occurrence of, and lines were also damaged. consequences of climate reminder that these gaps still
vulnerability to, disasters. Fiji is Total cost of damages was change, specifically, more need to be addressed.
an independent island nation estimated at FJD36 million frequent seasonal cyclones, The challenge is to make
in the southern Pacific Ocean. (US$ 23.8 million). Access to landslides and storm surges, hospital administrators,
Fiji experiences maximum and restoration of clean water and rising sea levels leading policy-makers, and other
rainfall between the months of supply, provision of food to floods. In stakeholders
January and March. Between supplies, and prevention of addition to Island countries are more aware
the months of November and waterborne and vectorborne injury and among the most vulnerable of the need to
April, Fiji is prone to tropical diseases were priority areas of drowning, to the consequences of ensure safe,
cyclones, of which there are 10 concern in the relief efforts. health risks climate change. functional
to 15 ravaging the country per Fortunately, no major associated and resilient
decade. damages to health facilities with these hazards are health facilities. Indeed, the
Starting 8 January 2009, or casualties among health malnutrition, scarcity of fresh goal of disaster risk reduction
the Western and Central personnel were reported. and safe water resulting in and of safe hospitals and
Divisions of Fiji were hit by But hospitals in Ba, Nadi higher rates of diarrhoea, health facilities should be
two consecutive tropical and Sigatoka had to rely on dengue, typhoid, and other approached with more fervor
depressions, resulting in heavy backup power and water waterborne, foodborne and urgency in regions with
rainfall and strong winds. supply for several days, and and vectorborne diseases. an inherent and, as is the case
The resulting floods mostly had to operate on skeletal Psychosocial concerns also of Fiji, increasing vulnerability
affected the low-lying areas staff. Health centres in the arise as increasingly larger to natural hazards.
of Rakiraki, Nadi, Ba, Nadroga Central and Western Divisions populations are threatened For more information visit
and Wainibuka in the Western were also flooded. with displacement. http://www.wpro.who.int/sites/
Division. At the height of the Fiji is no stranger to Gaps previously identified eha/disasters/2009/fij_tropical_
disaster, more than 11 500 environmental hazards. The on the activities concerning depression/list.htm. The report on
people were displaced in 169 country has experienced more safe hospitals in the country Fiji’s Safe Hospitals was presented by
centres. damaging natural disasters were: (1) lack of emphasis on Dr Eloni Tora, Ministry of Health of
Crops were damaged in the past and will continue the issue of safe hospitals, Fiji, during the Regional Consultation
and over 100 roads, crossings to do so in the years to come. (2) absence of building on Safe Hospitals, 8-10 December
and bridges in the Western Perhaps more importantly, maintenance plans, and 2009, Phnom Penh, Cambodia

Philippines
Safe Hospitals Start with Safe Buildings

The Philippines has a long One aspect of providing safety

history of natural and human-
generated disasters. Major typhoons
and heavy rains bringing floods,
earthquakes, landslides and volcanic
eruptions affecting families and
communities are expected every so
often. To add to these, we hear of
armed conflicts, mass gatherings,
environmental emergencies, and
other human-generated and
technological emergencies with
their share of casualties.
in disasters and emergencies is to
create buildings that can withstand
these hazards. Awareness and
education on creating safe buildings
is an important step. Safe hospitals
start with architects and engineers
who understand and can design
buildings with disaster reduction in
mind. What is a safe building? How
do natural hazards affect buildings?
What factors should be considered
to build safe  continued on page 5

RECAP Regional emergency collaboration, action and preparedness page 4

 Cambodia
Revitalizing Health Centres by Learning
from Past Experiences
Over the past decade,
Cambodia has dealt with
more than its fair share of
emergencies brought by
natural hazards. In the last
10 years, the nation has
weathered major tropical
storms resulting in floods that
have taken hundreds of lives
and displaced thousands more.
The recent emergencies
have brought to light the
importance of having facilities
that can remain operational
in times of emergencies.
During recent tropical storms,
several key health facilities
were flooded, rendering some
only partially functioning and
others totally inoperable.
Faulty drainage systems in
some health facilities resulted
in further damage to hospital
equipment during flash
floods. Health workers faced
the challenge of extending
quality care in spite of limited
supplies and facilities. During
these emergencies, the
nation was unable to address
the increase in demand for
essential drugs and necessary
 Philippines: Safe Buildings continued
infrastructures? Does climate
change have any impact on the
safety of buildings?
Safe hospitals
Architects and
start with architects
engineers who
and engineers who
can build safe
understand and can
health facilities
design buildings with
must adhere to the
disaster reduction in
country’s building
mind.
codes, considering
the integrity of the structural and
roof frames with the types of
disasters that occur in a particular
locality.
But safety of hospitals in
disasters extends beyond the
page 5
equipment. The provision of
health services was blocked or
interrupted due to damaged
or destroyed infrastructure,
disrupting access to much-
needed lifelines during these
emergencies.
In light of these
problems, Cambodia has
taken advantage of this
opportunity to learn from
its past experiences. Some of
the health centres that were
damaged or destroyed in the
past have been redesigned
to withstand hazards such
as typhoons and floods. Six
health facilities have been
elevated to address the
problem of flooding, while
health centres located in
areas prone to landslides have
been relocated. All necessary
equipment and drugs now
have their own designated
areas for safe placement and
storage. Training has also
been done to upgrade the
capacity of health managers
in managing situations in
which they were previously
overwhelmed, such as those of
design. Other considerations
include the choice of location,
types of materials to be used,
compliance to
building and
occupancy permits,
and the capability
of construction
companies and
individual workers.
The choice of
location is crucial for a hospital to
survive floods, earthquakes and
strong winds. The auxiliary who
build the foundation, prepare the
concrete mixture and complete
the rest of the building must be
mass casualties.
Despite these
achievements, Cambodia
realizes that there is still much
to be done for its emergency
preparedness and response
programmes. There is a
need for a comprehensive
vulnerability analysis to
classify and prioritize facilities
according to their safety
and risk. Standards for the
construction of safe hospitals
and health centres as well as
for guidelines hospital disaster
plans in times of emergencies
must be set and implemented.
The definition of hospitals
aware and understand that the
infrastructure they build should
withstand disasters.
Building safe health
infrastructures covers a variety of
existing concerns in our society.
These include policies on the part of
government officials and hospital
administrators, implementation of
laws, regulation of professionals,
awareness and training of the
construction sector, finance and
resource management, close
monitoring of projects and human
resource development.
Inclusion of safe hospitals in
academic and training programmes
safe from disasters should be
clearly understood at all levels,
and guidelines need to be
developed for the assessment
and monitoring of the
construction of these health
facilities. With the assurance
of quality health facilities,
these centres will also
hopefully be able to provide
quality health care before,
during and after disasters.
Presented by Dr Khuon Eng
Mony and Prof Chhuoy Meng of
Calmette Hospital, Cambodia,
during the Regional Meeting on
Safe Hospitals, 8-10 December 2008,
Phnom Penh, Cambodia
is an essential element in
the campaign but in order to
achieve resilient facilities, the
entire spectrum of construction
from policies to design and
implementation must be taken
into consideration. This is why
collaboration among government
agencies, academic institutions and
the private sector is crucial.
Based on the presentation
of Arch Cristopher Espina of the
University of the Philippines, College
of Architecture, during the Regional
Meeting on Safe Hospitals, 8-10
December 2008, Phnom Penh,
Cambodia
EMERGENCY and HUMANITARIAN ACTION
 Philippines

A Safe Hospital Surviving a Major Typhoon

Dedicated staff and a functional emergency

management system were keys to continuing
essential hospital services during and after a
major typhoon.
The Bicol Regional preparedness response and
Training and Teaching recovery plan (HEPRRP)
Hospital (BRTTH) is a 250-bed that covered preparedness
facility designated as a heart, during the pre-impact
lung and kidney centre, in phase, response during the
Legazpi City, Bicol Region, in impact phase, and organized
the Philippines. activities during the post-
On 30 November 2006, impact phase. extend their duty hours. They government provided funds
Typhoon Durian (local When the coming typhoon transported patients to safer for the renovation of hospital
code name Reming), with was first announced, the areas and secured medical infrastructure.
a maximum wind speed of administration declared Code equipment and food. Within Now, BRTTH remains active
280 kilometres per hour, hit White, mobilizing the HEMS the first eight hours, 200 in taking care of the health
the region. The typhoon and advising unit heads to additional patients arrived needs of the people in the
destroyed much of the secure their respective areas. at the emergency room Bicol Region. Renovation of
hospital’s medical facilities Necessary personnel including creating the need to augment major areas made sure that
and equipment and cut surgeons, anaesthesiologists, Emergency Room staff. the building can withstand
off electricity, water and emergency and operating When the storm cleared, future typhoons that occur
communication systems. room nurses, and medical damages and the medical more than 20 times a year.
Inaccessibility and closure interns, remained within the status of in-patients were The organized hospital
of stores made it difficult hospital premises. rapidly assessed. staff ensure
to replenish supplies. Even Code Red was declared There were no Now, BRTTH remains that services
hospital personnel were after the astronomical agency major casualties. active in taking care can remain
injured because of the announced increase wind The hospital of the health needs of functional
typhoon’s rage. In spite speed to 280 kph. The hospital administration, the people in the Bicol during and after
of these misfortunes, the emergency incident command government and Region. a disaster.
hospital remained functional. system (HEICS) was activated. nongovernment This report is
Prior to the calamity, The HEMS, doctors, nurses, organizations collaborated based on the case presented by Dr
the hospital had trained and duty staff identified to achieve rapid restoration Rogelio Rivera, Chief of Hospital,
and developed its health possible problems and drew of electricity, water and BRTTH, during the Third Asian
emergency management staff out contingency measures communication systems. Ministerial Conference on Disaster
(HEMS). It also had established to minimize damages. The Management of logistics was Risk Reduction in Kuala Lumpur,
a hospital emergency personnel were willing to emphasized. The national 2-4 December 2008.

RECAP Regional emergency collaboration, action and preparedness page 6

 Nonga General Hospital, Papua New Guinea: A Call for Policies
to Ensure Safe Hospitals
Papua New Guinea, with its
uniquely diverse natural landscape
and topography, is host to an
equally diverse array of natural
hazards, making it the most
vulnerable to natural disasters
among the Pacific island Member
States. Papua New Guinea is
situated on the boundary between
the Pacific and the Australian
tectonic plates and has eight active
volcanoes. Hazards that continually
plague the country include volcanic
eruptions, earthquakes, tsunamis,
tropical cyclones, large-scale
landslides, flooding, sporadic
droughts, frosts in highland areas,
and rising sea levels brought
about by climate change. Tsunamis
and landslides occur secondary
to earthquakes that occur with
regularity throughout the year. There
is also a high risk of technical and
human-generated disasters, such
as oil spills, industrial pollution and
unregulated and destructive land-
use practices.
In 1994, the Nonga General
Hospital was closed due to damages
inflicted by the eruption of the
Rabaul volcano, one of the country’s
most active volcanoes. Immediate
damages, such as structural
collapses, were noted due to the
weight of volcanic dust and debris.
Over time, volcanic dust and toxic
emission of sulfur dioxide gas
resulted in corrosion of
building materials and
air-conditioning units,
as well as corrosive
damage to hospital
equipment. Beds were
reduced from 450 to
a mere 30 beds for
emergency use. Having
its operating rooms
closed, the hospital
also lost its capacity to
conduct major surgeries.
The depth of
damage to the hospital
page 7
extended beyond the resulting
structural failures. Health personnel,
as much a pillar of the health
system as the elements that keep
the hospital standing, are equally
vulnerable. Many hospital staff
with chronic respiratory problems,
such as asthma, were forced to
transfer. With structural damage
and functional losses, as well as loss
of health personnel, the remaining
hospital staff suffered from very low
morale.
The economic impact of this
disaster was due to loss of expensive
hospital
equipment Past experiences and ever-
and high present hazards continuously
maintenance emphasize the pressing need
cost for for new policies to ensure
buildings, hospitals safe from disasters.
equipment,
and vehicles. For the hospital’s
remaining staff, the cost of living
became increasingly burdensome,
and hardship allowance was thus
introduced as part of their benefits.
Over the next years, Nonga General
Hospital would be closed and
reopened several times due to the
volcanic eruptions.
After more than a decade, the
government finally granted the
request for hospital relocation to a
safer zone. However, several other
hospitals in the country continue
to stand in hazardous areas which
make them prone to damage or
destruction from natural disasters.
To name a few, Wewak Hospital
stands on a tsunami risk area while
Kimbe Hospital is flanked by not
one but two active volcanoes. Lae
Hospital, the only national referral
hospital for cancer patients, stands
on a tectonic fault which puts it at
constant risk from earthquakes that
can cause spillage of radioactive
material.
Thus, there is a need to
strengthen policies on site selection,
construction and development of
health facilities
in Papua New
Guinea. Similar
to the experience
of Fiji, past
experiences and
ever-present
hazards in Papua New Guinea
continuously emphasize the
pressing need for new policies to
ensure hospitals safe from disasters,
as well as policies on minimum
standards for hospital safety. As a
prerequisite to these, there exists
the need to increase advocacy and
awareness of politicy makers, health
professionals and the communities.
Presented by Dr Victor Golpak,
Papua New Guinea Ministry of
Health, during the Regional Meeting
on Safe Hospitals, 8-10 December
2008, Phnom Penh, Cambodia
 Malaysia: Communication is Vital continued
response, Malaysia has
taken a more proactive
stance, rather than
its reactive approach
from before. Hospitals
serve as vital centres of
communication during
disasters. Information
in times of crises is an
essential resource and
hospitals are a critical part
of the communication
network that must be
in place in times of
emergencies. Hospitals
need to establish and
maintain efficient and
effective communication
with all agencies involved.
In Malaysia, emphasis
has been placed on
establishing swift and clear
communication during
disasters; the nation is
strengthening its intra-
agency communication
(seamless bottom-to-top
transfer of information
and vice versa) as well
as improving its inter-
networking (establishment
of medical emergency
call centres nationwide
with direct links to lead
government emergency
agencies). Malaysia is
currently updating its
emergency response
plans in order to provide
equitable access to health
care both in and out of
disasters. An ounce of
prevention is still worth
more than a pound of cure.
Presented by Dr Ahmad
Tajuddin Mohamad Nor and Dr
Mohd Safiee bin Ismail of the
Ministry of Health of Malaysia
during the Regional Meeting on
Safe Hospitals, 8-10 December
2008, Phnom Penh, Cambodia
EMERGENCY and HUMANITARIAN ACTION
Viewpoint
Are YOU prepared for Hospital Disasters?
It is 11:26 AM.
You are in the middle of surgery. What was expected to be a routine procedure has turned into a difficult case. Hunger pangs subtly begin to creep
into your stomach. The patient has lost a lot of blood, but the anesthesiologist reports that vital signs are still stable. You continue with your work.
Suddenly, the ground begins to shake. You hear the instruments rattle violently on the metallic table. It does not stop, and seems to be getting
stronger with each vibration. Your team is suddenly quiet. There is frantic chatter from the nurses outside. Without warning, electricity goes out. The
back-up generator does not turn on. Emergency lights create tall shadows in the operating room. There is a strong hiss growing from the gas line. A
scream is faintly heard from far away. The worst has happened. Do you know what to do?
The scenario above may sound What I have come to realize value of conducting these activities, committee or similar bodies.
like something from a movie, but it in this endeavor is that plans are very few are willing to pay the Second, ask when emergency
could just as easily happen in your only as good as the people who price. Exercises are perceived as exercises are scheduled in your
hospital. Or, in some similar fashion, use them. This pertains not only to cumbersome, labour intensive, institution. It may be that exercise
just as easily happen to you. In this those who carry out these plans time–and resource–consuming activities are in place, and you just
scene, you could be the scrub nurse, during emergencies, but also to the activities. Even in hospitals where have not been informed of them.
the first assist, the surgeon-in-charge, emergency management committees specific standards for emergency Taking part will not only let you learn
or possibly even the patient. Have that evaluate them, update them, preparedness are already in place, more about emergency plans, but
you ever considered and teach them often due to requirements for also provide a good opportunity to
When our hospital
whether your hospital to others. One of accreditation, these standards often interact with other individuals from
staff is unprepared and
is prepared for the best tools in never extend beyond the written your institution.
poorly trained, we place
disasters? And more accomplishing page. Ironically, there is usually Third, volunteer to help the
not only ourselves and the
importantly, are you? these tasks is only renewed or increased interest emergency management committee.
institution at increased
It is evident that through the use in risk reduction practices after the By doing this you can actually have
risk, but also the patients
hospital personnel of emergency experience of a recent disaster, only a direct hand in shaping how your
we take care of, and are
respond to disasters exercises. to die down later. hospital will respond to emergencies.
responsible for.
depending on how Conduction Yet despite these challenges, This will benefit your institution, and
familiar they are with hospital of these exercises is a venue for emergency exercises have been will also let you work with other like-
emergency plans, and how well they training, assessment, evaluation and identified as a critical component of minded people.
were trained in implementing these improvement. preparedness. Moreover, when done Finally, join in the Hospitals Safe
procedures. When hospital staff are Often when we think of properly, the risk reduction and life- from Disaster advocacy. The general
unprepared and poorly trained, we emergency exercises, what saving potential of these exercises population is only recently gaining
place not only ourselves and the commonly comes to mind are fire more than validate their necessary awareness of the importance of
institution at increased risk, but also or earthquake evacuation drills. place in routine practice for all hospital emergency preparedness.
the patients we take care of, and are However, emergency exercise hospitals and health facilities. Promoting these concepts can help
responsible for. Personnel training activities also include orientation, In the midst of all this, what can acquire support from key decision
and development must be an integral and tabletop discussions on you do? makers who can translate them
part of any emergency preparedness emergency operations plans, or First, be familiar with your into policy, and allocate appropriate
programme. No emergency plan functional and full-scale exercises hospital emergency plans and resources. You can take part in this
will work if no one knows how to which actually test and put these procedures. This is one of the best movement.
implement it. plans in action. Each exercise steps for you to be able to personally In the end, what is ultimately
Over the past two months, I type has its own strengths and respond to emergencies. It can necessary is sharing in the vision of
have been involved in a Hospitals limitations. Complex exercises more outline for you what the hospital’s keeping hospitals safe. Do it because
Safe from Disaster Campaign closely simulate reality; however, policies are, as well as your role and it reduces risks for yourself and for
Project that aims to come up with they are also more difficult to responsibility in emergency response. your patients. Do it because these
guidance materials to assist hospital organize and require more resources. For larger centres, this information simple activities can help save lives.
and health facilities in conducting Although most hospital can usually be accessed from the
emergency exercises. administrators would agree on the hospital’s emergency management Cesar Vincent L Villafuerte III, MD

For more information about Emergency and Humanitarian Action in the Western Pacific Region, The Regional Roll Out of the Safe Hospitals Campaign Editorial Staff:
contact:
is supported by the European Commission
Humanitarian Aid department Dr Arturo M Pesigan
EMERGENCY and HUMANITARIAN ACTION
Dr Lester Sam Geroy
World Health Organization E-mail: eha@wpro.who.int Dr Rene Andrew Bucu
Regional Office for the Western Pacific Phone: +632 5289810 Dr Paul Andrew Zambrano
United Nations Avenue, PO Box 2932 Facsimile: +632 5289072 Ms Glessie Salajog
1000 Manila, Philippines Mr Zando Escultura
RECAP Regional Emergency Collaboration Action and Preparedness is the Newsletter of the Emergency and Humanitarian Action Program of the Regional Office for the Western Pacific of the World Health Organization.
The reported events, activities and programs do not imply endorsement by WHO-WPRO and the statements do not necessarily represent Organization policies.

RECAP Regional emergency collaboration, action and preparedness page 8