Hospital Safety Screening & Comparison with 2015 Earthquake Damage, Nepal

Using the the Global Hospital Safety Index, we had evaluated two hospitals in Kathmandu just a few months before the April 2015 Gorkha earthquake impacted the city. This pre-earthquake snapshot of the hospitals’ seismic vulnerabilities provided an unusual opportunity to study whether this screening tool predicted how the hospitals would function after an earthquake.

 

The Global Hospital Safety Index helps health facilities assess how they might fare in major disasters. Developed by the World Health Organization (WHO), the Index checks for preparedness factors that will affect how staff can deliver care in challenging post-disaster conditions. It covers not only the physical buildings but also the function of utility systems and the degree of emergency planning.

 

The findings help decisionmakers understand vulnerabilities ahead of time. The report prioritizes actions to take now, such as triage training, that will greatly improve function during times of crisis.

 

GeoHazards International contributed suggestions when the Index was revised in 2014-2017. With WHO we conducted the first field tests of the revised tool. One of the locations was Kathmandu, where earthquakes are the primary disaster threat. We evaluated the National Academy of Medical Sciences (Bir Hospital) and Sukra Raj Tropical and Infectious Disease Hospital (Teku).

 

Bir is Kathmandu’s largest hospital and offers medical specialties as well as care to the city’s poor. The major trauma hospital, Bir is expected to provide essential post-disaster care and in fact treated a large number of 2015 earthquake victims. Teku treats patients with diseases such as cholera and typhoid. Because of its strategic location, Teku will need to provide general medical care after an earthquake. In 2015, some people sought care at Teku and were transferred to Bir.

 

At the request of WHO, we returned to Bir and Teku hospitals to document damage and to compare pre- and post-earthquake observations. Results led to suggestions for improving the Index and making modifications to it for the context of Nepal. Every region in Nepal faces a high risk of earthquakes, because the active fault that produced the Gorkha earthquake lies beneath most of the country. WHO’s country office in Nepal intends to update the Index and use it to evaluate hospitals nationwide.

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Project funded by World Health Organization (WHO)