Improving Hospital Earthquake Safety in India

Location: India
Time frame: 2007-present

The Problem

GHI Staff member assesses the roof system and suspended equipment at a hospital building in Assam, India

The same geologic activity that has given rise to the Himalayan mountains creates high levels of earthquake risk throughout northern and northeast India. Hospitals located in these areas are vulnerable to earthquake damage and at risk of losing the ability to function precisely when the community needs them most.

Earthquake damage to hospital equipment, building systems, architectural elements, and furnishings can render hospitals inoperable, even when their structural systems (i.e., beams, columns and bearing walls) are undamaged. Patients and staff can be injured by falling objects, or by disconnected life support systems. Building systems, such as air conditioning or fresh water piping, and expensive medical equipment can be damaged or destroyed. Hospitals in India have just begun to address their seismic risks, and much work remains to be done.



GHI’s Response

hospital_manual_coverSupported by funding from Swiss Reinsurance Company (Swiss Re), GHI is working to improve hospital earthquake safety in India. GHI and Swiss Re began by raising the earthquake risk awareness of more than 250 administrators and staff members from over 100 hospitals in the Delhi metropolitan area through a workshop in held in partnership with the Delhi Disaster Management Authority in 2008.

Next, GHI developed a manual that provides guidance hospital administrators and hospital staff can follow to mitigate the hazards caused by falling, sliding or toppling objects during earthquakes. The manual, Reducing Earthquake Risk in Hospitals from Equipment, Contents, Architectural Elements and Building Utility Systems, provides technical education for hospital administrators, staff, engineers, and construction contractors.

Click here for information on how to download the hospital earthquake safety manual free of charge.

The introductory sections of the manual are written primarily for hospital administrators, conveying to them the importance of mitigating earthquake falling hazards. The primary users of the manual’s technical chapters will be hospital maintenance and engineering staff. The manual contains guidance on how to anchor many common items, such as medical equipment, furnishings, pipes and ducts, tanks, mechanical and electrical equipment, and architectural elements. The manual was reviewed by experts in structural engineering, hospital operations, communications, and risk education from around the world. GHI is disseminating both printed and electronic versions to hospitals and government health departments throughout India.

GHI is currently working to implement the manual’s guidance in hospitals located in India’s zones of high earthquake risk. To do this, GHI developed training materials for doctors, nurses, and maintenance and facilities personnel. The training materials include presentations, interactive exercises, instructor guides and student guides. The instructor guides and student guides can be downloaded below, and the full set of training materials are available upon request.

GHI is using the training materials as part of earthquake safety programs in two pilot hospitals in Delhi. With Swiss Re’s support, GHI plans to expand these efforts to reach more hospitals in India.

The Results

  • Raised earthquake safety awareness of more than 450 hospital administrators and personnel as of December 2010
  • Published the manual Reducing Earthquake Risk in Hospitals from Equipment, Contents, Architectural Elements and Building Utility Systems and made it freely available by posting it on our website for download
  • Informed more than 800 hospitals of the manual through a direct mail campaign offering them free printed copies upon request
  • Evaluated one hospital in northeast India as of December 2010 to identify potential hazards, and provided recommendations for mitigation actions.
  • Developed training materials to help hospitals remain functional after earthquakes


Instructor Guide – Short Course for Doctors (English)
Instructor Guide – Training Course for Nurses (English)
Student Guide – Training Course for Nurses (English)
Instructor Guide – Training Course for Maintenance and Facilities Personnel (English)
Instructor Guide – Training Course for Maintenance and Facilities Personnel (Hindi) – coming soon
Student Guide – Training Course for Maintenance and Facilities Personnel (Hindi) – coming soon


    GeoHazards International

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    A 501(c)3 non-profit founded in 1991