The National Referral Hospital in Honiara sits directly on the coast, at 1.5-2 meters above mean high tide, and close to the mouth of a river. Often over-capacity in normal times, the hospital will need to care for many more people immediately after a disaster. Will it be able to function? With our partner the World Health Organization (WHO), we evaluated site vulnerabilities, buildings, utilities, equipment, and disaster preparedness at the major hospital serving the Solomon Islands.

 

Cyclones pose the greatest threat, bringing storm surge, high winds, heavy rain and river flooding. A direct hit would likely destroy or severely damage most hospital buildings. The region also faces high risk of earthquakes and volcanic eruptions. A tsunami greater than two meters is likely to cause devastating damage. Sea level rise, coastal erosion and rain-induced landslides are ongoing concerns. 

 

We determined that the current site is not at all suitable for a critical hospital. Our recommendations:

• Relocate the hospital to a site not exposed to coastal flooding or erosion.

• Ensure that the new inland site is not exposed to earthquake faults, landslides or river flooding.

• In the short term, secure items from falling in and earthquake; protect utilities from damage;  and relocate critical care wards.

• Plan and practice evacuation and response roles with staff.

 

Our findings--from initial field reconniassance, local geology, maps, and satellite imagery--indicate that the site selected for the hospital’s relocation has potential karst conditions (sinkholes, caves), faults, and flooding from nearby streams. These hazards need to be further evaluated through geologic and geotechnical studies.