Tropical Cyclone (TC) Haiyan, a Category 5, was the most devastating typhoon to make landfall in the Philippines and one of the worst disasters to hit the world in 2013. The impact was too depressing as debris and human corpses amass on once prolific communities. Images of persons injured and those wanting immediate medical attention were common scenes in the aftermath. This was due to the damages wrought in 38 hospitals, 97 rural health units, 296 barangay health stations, and the Department of Health (DOH) Regional Office in Eastern Visayas (DOH, 2013). For government owned health facilities alone, the cost of damage reached PhP1,272.4 million (NDRRMC, 2014) or USD28.3 million. This figure includes more than PhP300 million on medical equipment losses (NEDA, 2013). On the other hand, damages to private health facilities reached PhP1,959.9 million (NEDA, 2013). The Technical Discussion held at the Office of the Department of Health Secretary on January 21, 2014, envisages the hospital as the last building standing in the community amidst a disaster.
The aim of the government is to build back better and safer hospitals. This was endorsed by the World Health Organization (WHO) in the Philippines as the objective for rebuilding. The National Economic and Development Authority (NEDA) estimated the reconstruction needs of these health facilities at PhP6,887.4 million and set 2014 as the year to restore the health services (NEDA, 2013). The proposed amount includes infusing resilient standards in the reconstruction of these critical public facilities and the development of stronger health system. These improvements can be grouped into structural, non-structural and functional components.
For structural and non-structural components, the technical group first proposed that the location of hospital buildings should be considered first in the construction process. This recommendation is crucial as at least 7 hospitals in Tacloban were damaged due to the storm surge, which during the ferocity of TC Haiyan reached about 5-6 meters. Another proposal was to ensure that the building will have the right structural design, method, and will undergo proper maintenance based on the National Structural Code of the Philippines. It was evident during the disaster that roofs have been ripped off due to not following the standards. TC Haiyan’s maximum sustained winds was 235 km/hr and severe gusts of 275 km/hr. EMI proposed the conduct of flood risk assessment for hospitals identified within flood-prone areas and that location of hospital equipment and generators should be assessed with respect to flooding. This includes a program by the hospital for bracing of equipment. It is interesting to note that PhP1,101.3 million were lost due to damages of equipment and medicines (NEDA, 2013). Structural evaluations of hospital buildings built before 2001 were proposed to be undertaken by the hospital within a reasonable timeframe. Such evaluations will provide a more objective assessment of structural integrity of hospital facilities. Also, hospital engineers and facilities managers were encouraged: 1) to do regular structural inspections to detect any potential cracks or distress in the buildings, and 2) setting up for preventive maintenance program. The group finally proposed improvement to the structural code i.e. to consider other hazards; namely: 1) man-made, 2) landslides, and 3) storm surges.
To develop a stronger health system, additional hospitals functions were proposed. Recommendations were made to create an emergency operation center (EOC) for each hospital including privately owned ones. EMI proposed that the EOC must be in a safe location, fully equipped with all the necessary equipment and self-sufficient in terms of power, water, food, communication and sanitation. The space within the EOC should be pre-assigned with necessary supply. Also, the EOC must comply and align with the HEMS design and criteria. Aside from the EOC, the group recommends that all hospitals must formulate a business continuity plan.
The forum was a first step in the process on what should be done in the reconstruction phase particularly the aim to build back better and safer hospitals. Recommendations have just been elicited from different experts and organizations during the technical discussion. The recommendations and suggestions from other forums would be best translated to actual specifications for a model design of a resilient hospital.
Retrieved from Department of Health: http://dev1.doh.gov.ph/content/doh-goes-full-throttle-typhoon-yolanda-victims
Retrieved from National Disaster Risk Reduction and Management Council: http://www.ndrrmc.gov.ph/attachments/article/1125/NDRRMC%20Update%20re%20Sit%20Rep%2092%20Effects%20of%20%20TY%20%20YOLANDA.pdf
Retrieved from National Economic and Development Authority: http://www.neda.gov.ph/wp-content/uploads/2013/12/RAY-DOC-FINAL.pdf