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BACKGROUND OF THE MEETING Approximately 50% of the 15,000 hospitals in Latin America and the Caribbean are located in high-risk areas. In the last 20 years, more than 100 hospitals and at least 1,000 health care centers in this region were damaged as a consequence of natural disasters. The direct cost of these disasters has been enormous, not only were health services lost (including the interruption of urgently needed health services), but in some cases the collapse of hospitals caused the death of occupants.
Where and when the meeting took place The meeting was held in San Salvador, El Salvador from 8 -10 July 2003. Agenda
The meeting was sponsored by
PAHO/WHO also acknowledges the financial support of the Canadian International Development Agency (CIDA/IHA); the Department for International Development of the U.K. (DFID/CHAD); and the Office of U.S Foreign Disaster Assistance (OFDA/USAID). |
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Recent
major disasters in the Americas—including Hurricane Mitch, the landslide
in Venezuela, the earthquakes in El Salvador, Hurricane Isidore, the Peruvian
earthquake and others—have yielded valuable lessons regarding damage
to health facilities and solutions to lessen the impact on critical infrastructure.
This experience, coupled with the conclusions of the regional meeting
on hospital disaster mitigation held in 1996, points to the need to examine
more closely three main topic areas: disaster mitigation, hospital evacuation
and the use of foreign field hospitals. 
In
this context, existing regulations concerning the design and construction
of health facilities must be revised and enforced, reorienting them toward
disaster mitigation, with the ultimate goal of protecting
the lives of patients, staff and other occupants and ensuring that these
facilities can continue to function during and after a disaster strikes.
The knowledge on how to build safe hospitals exists and is accessible.
At
some point during an emergency or disaster, it may be necessary to evacuate
hospitals. But unnecessary evacuation can lead to serious problems, including
the reintegration of a health facility into the health services network,
which could take several months. The topic of when to evacuate a hospital
will be discussed. 
When
hospitals are evacuated, one way to provide immediate medical care to
victims of natural disasters seems to be the mobile field hospitals
that many Western countries maintain for their defense forces. Some political
authorities in disaster-affected countries have accepted the donation
of self-contained field hospitals as a temporary substitute for health
facilities damaged by disasters. However, often these foreign hospitals
have not met the expectations, generating frustration and disappointment
for all parties concerned: recipients and donor countries, the medical
staff and the patients. On several occasions, field hospitals contributed
to deterioration of health conditions among the affected population and
delayed a return to pre-disaster levels.
