Hospital Safety

Hospitals are critical infrastructure that has an extremely important  role in the post-disaster scenario. Many past disastrous events have  left hospitals non-functional. It is also not enough that the hospital  building is strong enough to withstand the effects of a disaster, but  all the critical equipment and services in the building have to remain  secure and operational to operate at over 300% of its design capacity to  serve the dependent community after any disaster like an earthquake,  flood, major fire, and terror attacks. There is a need for a higher  level of preparedness to manage the incoming patients and provide them  with the best facility. It is important that the decision-makers and  other staff in health facilities understand the importance of the  factors affecting functional continuity and take steps to mitigate  these. 

Making a health facility safer is as much about having vision and  commitment as it is about actual resources. However, ensuring that the  hospital is disaster-resilient goes beyond the physical structure and to  ensure that all these hospitals are functional and continue to provide  emergency health care after a disastrous event, it is critical we ensure  the staff members of the hospital are prepared to respond to such  events.

GeoHazards Society (GHS – www.geohaz.in)  has been working with hospitals across India and neighboring countries  such as Bhutan, Nepal, and Myanmar, etc. with this mission to keep  hospitals safe as well functional from various natural hazardous events  with its international partner GeoHazards International (GHI – www.geohaz.org)   GHS has done extensive work towards hospital safety and functionality  with national and state governments as well as international  organizations such as WHO, UNDP. 

Work with NDMA with support from Swiss Reinsurance Company India

In between 2008-2015, we have developed a Non-structural risk  reduction manual and implement it in 8 major hospitals, conduct a number  of workshops, one at Delhi with NIDM and the other at Agartala with  TSDMA. 

The key activities included: 

• Implementation of a program that prepares hospitals to be  functional after an earthquake, by backing up utility systems, anchoring  heavy objects, and planning how to evacuate
• Developing a manual  and training class to instruct hospital administrators, engineers and  maintenance staff how to identify and mitigate risk from things that, if  they fail or fall during any incident, will disrupt medical care and  safety of patients (utility systems, medical equipment, furnishings,  pipes, tanks, mechanical and architectural elements)
• Taught disaster safety awareness and preparedness planning to more than 450 hospital administrators and facilities personnel.
• Developed  training materials for doctors and nurses that included presentations,  interactive exercises, instructor and student guides. 
• We have  implemented the guidance and trained staff in 8 major hospitals: Bhagwan  Mahavir Hospital (Delhi); Jai Prakash Narayan Apex Trauma Centre of the  All India Institute of Medical Sciences (New Delhi); Deep Chand Bandhu  Hospital (Delhi); Acharya Shree Bhikshu Hospital (Delhi); Agartala  Government Medical College and Hospital (Tripura); Tripura Medical  College and Hospital (Tripura); L.N.J.P. Hospital (New Delhi); Medanta  Medicity (Gurgaon), held workshops to train staff from additional  hospitals in Delhi and Tripura how to maintain hospital functionality  during disasters and distributed the manual throughout India, and made  it available for download online. 

Reducing Earthquake Risk in Hospitals – from Equipment, Contents, Architectural Elements, and Building Utility Systems 

(This manual is a copyrighted document being provided to you solely  in order to help you to reduce your earthquake risk. You are free to  download, distribute and transmit this Manual, under the following  conditions.)

This manual was made possible by the support of Swiss Re.

This manual will help reduce sources of earthquake-related damage and  losses in hospitals as it considers medical equipment and supplies,  contents, architectural elements, and building utility systems. Previous  hazardous events depict that damage to any of the aforementioned items  has caused deaths, injuries, loss of the building’s functionality, and  contributed to the overall economic loss.

The manual contains the following information:

• Determine your hospital’s earthquake risk
• Identify items that could fall, slide or topple and injure people
• Anchor and brace the items that might fall, slide or topple to reduce risk
• Prioritize actions to reduce risk according to your hospital’s needs and budget
• Other steps to take to make your hospital safer

Please watch the video to understand more about the need of this manual. Click here 

You can also download the Disaster Safety Checklist for Hospital Administrators by clicking here.

Work with National Referral Hospital supported by WHO Bhutan and Ministry of Health, Bhutan

• In between 2012-2013, we partnered with GeoHazards International  (GHI) and worked with Jigme Dorji Wangchuck National Referral Hospital  of Bhutan located in Thimphu. We have evaluated the structural and  non-structural elements as well as the overall disaster preparedness of  JDWNRH. Documented the hospital’s seismic vulnerabilities. Recommended  earthquake safety improvements: anchoring, improving critical back-up  systems, and other mitigation measures to support post-earthquake  medical care delivery. We also highlighted the need to formulate an  emergency plan for the hospital and undertake the training of hospital  staff. 
• GHS also assisted GHI in conducting the Seismic Vulnerability Assessment of Trashiyangtse and Tashigang district hospitals.

Work with Ministry of Health, Nepal and WHO Nepal

• In between 2011-2014, we assisted GHI and have worked with the  Ministry of Health, Govt. of Nepal to assess three major hospitals in  Nepal. The major activities included recommendation and prioritization  both short-term and long-term changes to improve post-disaster  functionality of three hospitals that provide critical medical services  for a large number of people in Kathmandu: Paropakar Maternity and Women’s Hospital, National Academy of Medical Sciences (Bir Hospital), and Kanti Children’s Hospital. 
• We  conducted an initial seismic evaluation. Identified non-structural  elements and contents that threaten each hospital’s ability to function  post-earthquake. Assessed vulnerabilities in areas that deliver care,  on-site utilities, specialized medical equipment, and architectural  shell.

Work with GNRC, hospital, Guwahati

• In 2015-2016, we worked with GNRC hospital, Sixmile and Dispur  branch to conduct assessment and improvement of disaster readiness. We  have sensitized all the staff members of the hospital and helped them  develop a hospital disaster preparedness plan for emergencies. The plan  was tested by conducting a tabletop exercise in the hospital along with  the hospital administrators. GeoHazards Society also conducted  Non-structural risk assessment for the entire hospital and a fire safety  assessment, the findings of the assessment were shared in the form of a  report with the hospital. 

GHS has been working in hospital  safety in highly vulnerable areas of the country with various state  governments. We have organized training programs on hospital safety for  major hospitals including AIIMS, GTB hospital, etc. 

• Organized one day workshop on ‘Keeping Hospitals Functional in  Disasters’ with International resource persons in partnership with NIDM  and GHI on 5th Sept 2014. A similar workshop was also conducted in  Agartala in September 2014 in partnership with the Revenue Department,  Govt. of Tripura. 
• Hospital Safety Training to Hospital  Administrators on Non-structural Safety (Guwahati, November 2010):  Training was organized for Medical Superintendents from various  Hospitals in Assam with coordination between the ASDMA and the  Department of Health, Govt. of Assam. 
• One day training program  for the doctors and hospital administrators in Shimla organized by  Himachal Pradesh State Disaster Management Authority.
• Conducted a  comprehensive hospital disaster preparedness program and tabletop  exercise in Tripura Medical College and Agartala Medical College where  all the hospital’s medical and non-medical staff was trained and the  disaster Management plan evaluated with tabletop exercises.
• Hospital  Safety Training to Hospital Administrators on Non-structural Safety for  Kanpur District (Kanpur, October 2010) In collaboration with Revenue  Department and Department of Health, Govt. of UP.
• Hospital Safety Workshop in Jammu in collaboration with Govt. of Jammu & Kashmir, NDMA, and AIIMS. 
• GHS  conducted a non-structural risk assessment of six major hospitals in  Nepal in October 2014 in partnership with GHI and WHO Nepal. 
• A  compressive hospital safety workshop in Jammu Medical College in Jammu  and Kashmir has been carried out to train the medical and non-medical  staff members with the support of AIIMS, J&K Govt- and WHO in  December 2009. 
• A three days training program on Hospital  Disaster Preparedness and Tabletop Exercise at ILS hospital Agartala,  Tripura was carried out in March 2017. 
• Conducted Hospital Disaster Safety Workshop IGMC Shimla, Himachal Pradesh, with support from WHO India in November 2012.
• Coordinated  Hospital Safety Training to Hospital Administrators on Non-structural  Safety (Guwahati, November 2010): Training was organized for Medical  Superintendents from various Hospitals in Assam with coordination  between the ASDMA and the Department of Health, Govt of Assam. 
• GHS  has carried out a one and half-day hospital preparedness training and  tabletop exercise for hospitals, Shimla, Himachal Pradesh (HP) on the  19th and 20th of November, 2018. The program was conducted by two  resource persons from GHS with key medical personnel from various  district hospitals of Himachal Pradesh. 
• World Health  Organisation, India office, and GeoHazards Society, New Delhi organized a  series of workshops for Hospital Disaster Safety in five major  hospitals across India in five high hazard-prone cities. The cities are  Aizawl, Guwahati, Mumbai, Shimla, and Trivandrum. Each daylong workshop  was conducted from 23rd November to 2nd December 2011.  
• GHS was  invited by the St. Stephens Hospital, Delhi to organize a special  session on hospital disaster preparedness for the hospital staff. The  program was a one day program and besides addressing hospital disaster  preparedness the importance of social media and how it can help the  hospital was also discussed in detail with the participants.

Working with Navi Mumbai Municipal Corporation (Hospitals):

• Navi Mumbai Municipal Corporation (NMMC) in collaboration with  UNDP under the project Developing Resilient Cities through DRR and CCA  has taken initiative to ensure disaster preparedness in hospitals and  took technical support from GeoHazards Society for conducting training  programs on Hospital Disaster Preparedness for four Hospitals including  FRU Vashi, Apollo Hospital, and two General Hospital in Aeroli and Nerul  respectively. 

Working with Indira Gandhi Medical College, Shimla

• GoI-UNDP-USAID Project on ‘Developing Resilient Cities through  Risk Reduction in context of Disaster and Climate Change’, with Disaster  Management Cell, Municipal Corporation Shimla, Himachal Pradesh has  taken initiative to develop the Disaster Management Plan for the most  important Hospital named Indira Gandhi Medical College (IGMC), Shimla in  Himachal Pradesh. GHS has developed the disaster management plan for  the hospital. 

Working with WHO SEARO

• The WHO SEARO has initiated the development of a mobile phone as  well as a web-based application called HSI+ for hospitals in Nepal in  partnership with GeoHazards Society. The HSI+ App combines the rapid  assessment of structural, non-structural, and emergency and disaster  management of the hospital under the Hospital Safety Index along with  the basic contents of a hospital Disaster Management Plan. The App will  help the hospital administration understand the strength and weaknesses  in their hospital (structural, non-structural, and emergency and  disaster management) and also develop the basic hospital Disaster  Management Plan. The HSI+ App enables hospitals making them safer at  local, national, and regional levels in Nepal. 
• GHS along with its international partner GHI assisted the WHO SEARO in formulating 3 different checklist for fire safety in hospitals. The checklist are designed to for health care facilities which are operational from buildings and from tents (field hospitals). As part of the project, the checklists were field tested in Nepal and Maldieves where a group of hospital staff including administrators, doctors, nurses and technicians were trained on using the checklist to assess their health facilities. Besides this, an online session on fire safety was conducted by fire safety and disaster management experts for the country offices of WHO Nepal and WHO Maldieves. The program also involved testing of fire safety plans of the health facilities in the form of a tabletop exercise. 
• As part of our continuous support to the World Health Organization, GHS also revised the Hospital Safety App (HSI+) and incorporated the checklist on fire safety which can be used by health care facilities globally to assess themselves for fire hazards and also develop a hospital disaster preapredness plan.

Working with UNHABITAT and Govt. of Myanmar

• GHS in collaboration with GHI conducted a detailed assessment of  critical facilities in two major national hospitals in Yangon and  Mandalay in Myanmar under a project organized by UNHABITAT.
• A  detailed report of the findings is shared with the Ministry of Health  and UNHABITAT along with mitigation solutions for the identified hazards  in the hospitals.
• Besides the assessment, a small session was  organized for the senior medical and administrative staff of the  hospital where they were sensitized on the importance of assessment of  these hazards and why they need to be mitigated at the earliest.

Hospital Safety Assessment of Burrows Memorial Christian Hospital, Silchar, Assam

• GHS had partnered with Emmanuel Hospital Association (EHA) for  disaster preparedness in their hospitals. One Preliminary Seismic  Assessment of Structural & Non-Structural Components was done at  Burrows Memorial Christian Hospital in Silchar, Assam. Please click here  for the detailed report. 

3-day online training program on Building Resilience of Health Facilities with NIDM in Jammu & Kashmir

• A 3-day online training program on Building Resilience of Health  Facilities was successfully completed in close partnership with  National Institute of Disaster Management and Dept. of Disaster  Management, Relief, Rehabilitation and Reconstruction, Govt of J&K  from Oct 27 to 29th 2021. (Please click on the link to access the report)