Because of the variety and cost of mitigation activities, priorities for implementing these measures must be established. In the health sector, this is the function of the national health disaster management program, working with experts in such areas as health and public policy, public health, hospital administration, water systems, engineering, architecture, planning, education, etc. A specialized unit within the national health disaster management program should coordinate the work of these professionals. Mitigation complements the disaster preparedness and disaster response activities of the program.
The mitigation program will direct the following activities:
1. Identify areas exposed to natural hazards with the support of specialized institutions (meteorology, seismology, etc.) and determine the vulnerability of key health facilities and water systems.
2. Coordinate the work of multidisciplinary teams in developing design and building codes that will protect the health infrastructure and water distribution from damage in the event of disaster. Hospital design and building standards are more stringent than those for other buildings, since hospitals not only protect the well-being of their occupants, but must remain operational to attend to disaster victims.
3. Include disaster mitigation measures in health sector policy and in the planning and development of new facilities. Disaster reduction measures should be included when choosing the site, construction materials, equipment, and type of administration and maintenance at the facility.
4. Identify the priority hospitals and critical health facilities that will undergo progressive surveys and retrofitting to bring them into compliance with current building standards and codes. The function of a facility is an important factor in establishing its priority. For example, in earthquake zones, a hospital with emergency medical capacity will have higher priority in the post-disaster phase than a facility that treats outpatients or those who could be quickly evacuated. Create mitigation committees at the local level to identify key facilities and ensure that mitigation measures are implemented in all projects.
5. Ensure that disaster mitigation measures are taken into account in a facility’s maintenance plans, structural modifications, and functional aspects. In some cases, the facility may be well designed but successive adaptations and lack of maintenance increase its vulnerability.
6. Inform, sensitize, and train those personnel who are involved in planning, administration, operation, maintenance, and use of facilities about disaster mitigation, so that these practices can be integrated into their activities.
7. Promote the inclusion of disaster mitigation in the curricula of professional training institutions related to the construction, maintenance, administration, financing, and planning of health facilities and water distribution systems.
Annex I describes the steps involved in establishing a national disaster mitigation plan for hospitals in an earthquake-prone region.