Sustain the Initiatives to Keep Health Facilities Safe from Disasters in Bhutan

Think about the large number of people who will be injured, all at once, by a large earthquake—and how to treat them efficiently. The building needs to be safe and functioning in order to accept patients. It needs back-up systems for sufficient power and water. Equipment must be braced.

 

Doctors and nurses need to practice how they will adapt care amid damages. In mountainous Bhutan, the hospital and the district it serves may be isolated for long periods if earthquake-triggered landslides block key roads.

 

We worked with officials from the Emergency Medical Services Division of Bhutan's Ministry of Health and hospital staff to implement disaster preparations at four key hospitals across the country: Jigme Dorji Wangchuck National Referral Hospital, Mongar Regional Referral Hospital, Trashigang District Hospital, and Trashiyangtse District Hospital. 

 

Administrators, doctors, nurses and technicians planned how to evacuate patients from each building, triage the injured, manage patient surge, communicate with outside help, and deal with shortages of power, water and medicine. They learned through training sessions and hands-on simulations. Many found problems they could fix now (such as can’t evacuate ICU patients because the gurneys are wider than the door).

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But how much will they recall in a crisis? Medical staff had little experience with the chaos that a big disaster brings. That’s why, to cap off the planning and training, we coordinated mass casualty drills. Actors played patients and anxious family members--each with a story and some drama--in a scenario of a plausible major earthquake. (Homes will collapse. Parts of the hospital will be damaged. Landslides will block roads and sever utilities. Many will be injured.)

 

The drills help medical and other staff practice and remember what to do in their post-disaster roles. These first drills also tested the hospital's new disaster procedures. Gaps came to light. Staff took careful notes and made their disaster preparedness even better.

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