With this in mind, improved criteria for the various project development stages will be described in the pages that follow, and the procedures for selecting the performance objective will be specified. Definition and characterization of objectives for protecting infrastructural components 2 Once a protection objective has been set for the facility as a whole, as well as for each of its services, it should determine the organizational, safety, and control performance criteria for the prevention or mitigation of any damage to infrastructural components. In some circumstances it may not be possible to meet the desired performance objective due to the extreme conditions in which the reference population lives. The chief purpose of this handbook is to assist health sector administrators and professionals whose mission is the management, design, construction, and inspection of new hospitals, laboratories, and blood banks, with a view to protecting the infrastructure and operation of these facilities. Feasibility of controlling impact: Yes No Flooding Affected surface:. In this stage the services and spaces desired are defined and preliminary plans are drafted in order to determine the functional relations and basic characteristics of the new infrastructure. The protection systems that will be incorporated must then be included in the construction documents outlining the physical details of the system to be built: the technical specifications and the various plans.
This process must include the definition of the physical characteristics of the facility and its operation. Safety assessment of the structural system The specialists in charge of the structural design of the facility must be able to guarantee that the protection criteria set by the client institution will be met. The points of support of these components must enjoy a level of safety comparable to that of the components themselves. Of the 10 facilities affected, one had to be evacuated; two were subsequently demolished. The level of detail of the studies will also be determined, naturally, by the performance objective from life safety to functional protection chosen for the facility. The structural elements must remain nearly as rigid and resistant as before the emergency.
Technical knowledge and experience have taught us that it is possible to reduce to a minimum the risks and damage caused by disasters if preventive measures are incorporated early in the design, construction and maintenance of new health facilities. European Committee for Standardization, Eurocode 8: Design of Structures for Earthquake Resistance. In any case, the performance objectives must be the result of a joint agreement by the client institution, the medical team and the project specialists. It can be obtained free of charge from the Adobe Website. San Juan de Dios San Miguel and San Pedro Usulután Hospitals were severely damaged and provided partial services out of doors. At least 11 facilities had to be evacuated.
Feasibility of controlling impact: Yes No Hazard characteristics 2 Strong winds Likelihood:. A great number of professionals and experts in disaster mitigation have participated in the preparation and revision of this publication. Information required of consultants or specialists Certified resume 5 Name of project Client institution Financial amount of project Total built surface Total surface of project Period of execution Field of professional endeavor project director, designer, mitigation or other consultant, assistant, other Activities carried out by the professional only certified activities Field of activities Planning and feasibility Administration Basic engineering studies Engineering Architecture and urbanism Construction Inspections Varied studies Special expertise to be applied Experience in similar projects Evaluating the work teams Standards and codes applied 81 Chapter 6 6 Managing Project Quality 1. Other phenomena—such as drought, fire, or man-made hazards—have been excluded. The likely impact of the phenomenon on the health network of the region—and, where appropriate, of the country—must also be assessed. Any damage should be minimal and allow for immediate occupancy of the premises. The magnitude of an event cannot be controlled; its consequences, however, can be.
It emphasizes the substantial social and economic benefits of applying disaster mitigation measures to the design, planning and construction of health facilities. During the construction stage, it will be the responsibility of the design team to assist in the inspection of the work they designed, help in decision-making when unexpected circumstances or aspects not contemplated in the contract documents arise, assess the merits of any variation the contractor may propose, participate in specialized on-site inspections, certify the satisfactory completion of the various components, and recommend that interim payments be made. Based on this criterion, it is possible to design and build infrastructure that can resume operations within a reasonable time at a cost that can be met by the client institution. In the case of strong winds, protection efforts should focus mainly on exposed external components. For instance, if a seismic base isolation system is used, a discontinuity at the isolation interface will be required not only throughout the entire floor plan but also in the immediate perimeter in order to accommodate any displacements that may occur. Sources: Crónicas de Desastres Nº 8: Fenómeno El Niño 1997-1998, Pan American Health Organization, 2000; Health in the Americas, 2002 Edition, Volume I, Pan American Health Organization, 2002. Repairs may be expensive and interfere severely with the operations of the facility in the medium and even long term.
Continúa Glossary Resistant system 105 Guidelines for vulnerability reduction in the design of new health facilities 106 Risk Extent of the likely losses in the event of a natural disaster. Feasibility of controlling impact: Yes No Continúa Form for Site selection1 continued Mudslides Affected surface and volume displaced:. Building Officials Code Administrators International, International Building Code 2000. Basing the protection strategy on the latter scenario is the most desirable approach. The structural system and its components must be designed to withstand the permanent and potential forces that affect a structure, including its dead load its own weight as well as its live load the structure in operation , its seismic load, wind load, snow or ash load, temperature changes, hydrostatic and hydrodynamic soil factors, total and relative settlements of foundations, and so on, all of which are defined and regulated by existing design standards. Among the casualties were patients, doctors, nurses, administrative staff, visitors, and newborns.
However, no level of damage is acceptable if it puts the lives of the users or staff at risk. Most of the disaster-related deaths and injuries occurred in the two hospitals that collapsed. Accordingly, a compendium should be drawn up containing the specifications and other information that can ensure quality during the construction process. Organización Panamericana de la Salud, Mitigación de Desastres Naturales en Sistemas de Agua Potable y Alcantarillado Sanitario, Guías para el Análisis de Vulnerabilidad, 2000. Managing project quality Patrucco, H. Design of a medical-architectural program. The process for selecting potential sites Variables governing site selection It is not the purpose of this handbook to explain at length how to rank the various siting options.
General criteria for selecting a safe site The information obtained during the three stages of site selection must be summarized in a document that should contain, at the very least, the following: 45 3. When considering the overall safety of the infrastructure in question, it is common to divide its components in two groups: the structure itself, and the nonstructural elements. Project quality assurance during the preliminary and design stages. Stage 1: Compilation of background data Preliminary data compilation At the start of the project, the client institution must appoint a siting coordination team that must in turn hire the professionals who will advise on the correct selection of the project site. It is to be hoped that health-sector managers, professionals, and technical consultants entrusted with managing, designing, building, and inspecting new health facilities may benefit from its reading and discussion. The views expressed, the recommendations made, and the terms employed in this publication do not necessarily reflect the current criteria or policies of the Pan American Health Organization or of its Member States.
Peru 19971998 Floods associated with the El Niño phenomenon Fifteen hospitals, 192 health centers and 348 health posts affected. Among the selection criteria, the experience of candidate firms in the building of disaster-resistant health facilities should be considered. While adverse natural phenomena do not discriminate between industrialized and developing countries, their consequences can be very different. Major damage to systems, components, or equipment containing or involving harmful or hazardous materials may force the evacuation of some parts of the facility, resulting in a loss of operational capacity. The safety criteria chosen for each section have to be the same across all disciplines, and the ways in which these criteria will be satisfied must be established in advance by all teams. The purpose of such monitoring is to ensure that the project components for which each team is responsible are compatible with each other.