(PO 200072343)
Prepared by:
FIELD EPIDEMIOLOGY TRAINING PROGRAM ALUMNI FOUNDATION,
INCORPORATED (FETPAFI)
April 2009

i. Executive Summary ii. Introduction
Objectives iii. Presentation Highlights and Discussion a. Welcome Remarks b. WHO Message c. Keynote speech d. Presentation of Research Results: Capacity
Assessment of Metro Manila Tertiary Hospitals in
Responding to Emergencies/Disasters e. Launching of Hospitals Should be Safe from
Disasters, 2 nd Edition f. Launching of Guidelines for Health Emergency
Management (Hospitals), 2 nd Edition g. Launching of the National Student Design
Competition for Hospitals Safe from Disasters iv. Recommendations v. Annexes
A. Capacity Assessment of Metro Manila Tertiary
Hospitals in Responding to Emergencies/Disasters
B. Hospitals Should be Safe from Disasters
2 nd Edition
C. Manual of Guidelines for Hospital Operation
D. National Student Design Competition
(Hospital Safe from Disasters)
E. Program of Activities
F. Picture Documentation
G. Attendance
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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The spate of natural and man-made disasters especially over the last two years has generated a greater need for emergency preparedness. The impact of the damage and devastation to life and property is more strongly felt in
Asia, as it is among the world’s most affected regions. The World Disaster
Report in 2006 showed that 44% of all disasters took place in Asia, with 58% of total casualties of natural disasters from 1996
– 2005 coming from the region.
On top of its impact on population health, disasters exponentially affect the cost of damage and destruction to health-related infrastructure. This contributes further to the consequential economic burden particularly among developing countries.
Being an Asian country, the Philippines is no exception. The country hosts no less than 15 typhoons annually. Some of these typhoons have strengths that can wreck widespread havoc. The country also faces the risk of earthquakes; and has its share of perils from man-made disasters as well.
One of the more recent natural disasters that ravaged the country was
Typhoon Frank in 2008. Cost of damages left by the typhoon was estimated at PhP 400 million. It also left 127 health-related infrastructures, mostly in region VI, heavily devastated. Rebuilding the facilities not only requires a substantial amount, it also demands a decisive, and prompt joint-action among local governments, partners and concerned agencies.
This year’s World Health Day theme, Safe Hospitals: Protect Health
Facilities in Emergencies is most appropriate and timely for the Philippines.
Together with the Department of Health (DOH), the World Health
Organization (WHO) through its Western Pacific Regional Office (WPRO) launched World Health Day in Manila, Philippines on April14, 2009. With the year’s overarching theme of safe health facilities, the WHO and DOH jointly called on their partners to heighten their vigilance in ensuring the structural safety of hospitals and other health facilities.
The presentations during the launch allowed the participants to have a better appreciation of the annual celebration’s goals of improving health and how they, in their respective roles can do their share in achieving the objectives of attaining safe hospitals and facilities.
The launch also became the venue for the introduction of tools (handbooks, research results and guidelines) that can be referenced by hospital and health facility administ rators in assessing and developing plans for their facilities’ structural improvements.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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II.
The main focus of this year’s World Health Day theme focuses on the resiliency and structural safety of health facilities and the health workers who provide treatment and medical attention to people affected by emergencies.
Almost always, hospitals are the first point of refuge and safety in times of disasters. It is therefore imperative that their structural safety is assured at all times, especially during disasters.
Worldwide, the WHO and its strategic partners aim to highlight successes, advocate for safe facility design and construction, and build momentum for widespread emergency preparedness.
General Objective:
In the Philippines, the launch of the World Health Day enabled the WHO and the DOH to emphasize the importance of hospitals’ and health facilities’ structural safety.
While the two agencies commend the capability of the country’s health providers including their preparedness for emergencies and/or disasters, the WHO and DOH are also encouraging other public and private sector partners, especially hospital administrators, to also give an equal focus on the physical stability and readiness of their facilities.
Often, hospitals’ and other health facilities’ structural maintenance takes a back seat in terms of funds allocation. Budgets for most of the facilities ’ upkeep give way for the purchase of drugs, medical supplies and personnel costs.
Specific Objectives:
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To advocate to its partners the value of investing in health infrastructure
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To encourage strategic alliance among governments, academe, development agencies, etc. in ensuring the structure soundness of hospitals and other health-related facilities
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To elicit a more active support and participation from hospital administrators to ensure the structural soundness of their facilities
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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Topic
Date
: Welcome Remarks
: April14, 2009
Resource Person : Dr. Criselda C. Abesamis , Director IV, National Center for Health Facilities and Devices, DOH
In her remarks, Dr. Abesamis highlighted the DOH commitment in implementing the guidelines in the two manuals ( Hospitals Should Be Safe
From Disasters and Guidelines for Health emergency Management in
Hospitals, 2 nd Edition ) that hospital administrators can use as reference materials for the improvement of their respective facilities. To reiterate the national health agency’s commitment to the effort, she said the DOH likewise stands firm in its commitment to provide the funds to enable the administrators of the facilities to continuously ensure the safety of their facilities. This, in turn would ensure patient safety and quality care. She also shared with the group that the DOH had requested for and submitted to the
Department of Budget Management (DBM) a budget increase for 2010 –
2012. Part of the increase in the budget will be allocated for improvement of
DOH-retained hospitals. According to Dr. Abesamis, the DOH is currently advocating for the approval of its srequest.
She also commended the WHO-WPRO for their continuous support to improving the health of Filipinos through the various technical assistance and funds they provide to the DOH.
Topic
Date
: WHO Message
: April14, 2009
Resource Person : Dr. Gerardo P. Medina , WHO-WPRO Program Office
Representing Dr. Soe, WHO-WPRO Representative to the Philippines, Dr.
Gerardo P. Medina shared with the group the message that reiterated the
WHO’s support to the Philippine government in its achievement of its goals in ensuring the structural safety of hospitals and facilities in the country.
The message, while citing natural disasters as primary factors for emergency preparedness also cited other types of disasters that the country needs to be ready for. Among these are the risks and damages to both population and environment health caused by the capsizing of a cargo vessel near Bicol as an aftermath of typhoon Frnak. The cargo vessel was carrying chemicals when the typhoon hit and caused it to sink in the waters south of Luzon.
Dr. Medina said that the WHO is concerned with the health of the population during these situations and that hospitals and smaller health facilities are the people’s life lines in these times. He said that in the conduct of an assessment study, many of these facilities were found to be not prepared. Sadly, some were far beyond and deficit in their capabilities to provide their functions properly.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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The message called for the recognition of the political responsibility of hospitals in protecting the health and lives of the population before and especially during disaster times.
Dr. Medina ended the message with the assurance to administrators that ensuring structural safety of hospitals and facilities is not as costly as many would think; as there are strategies and guidelines already available to help administrators implement feasible steps to address concerns.
Topic
Date
: Keynote Speech
: April14, 2009
Resource Person : Dr. Jade del Mundo , Usec.-in-Charge for Corprorate
Specialty Hospitals and Special Concerns
Dr. del Mundo said that hospitals and health facilities, especially those ran and managed by government should do everything to ensure that maximum care is given to the citizens, before, during and after disasters. He said that on top of natural disasters, climate change and armed conflicts should also be considered and taken account for emergency preparedness.
He said that hospitals and facilities should be able to provide safety and not become calamities themselves. Dr. del Mundo emphasized that preparedness is key. He said that hospital preparedness or its lack of it becomes more pronounced in the wake of disasters. Outbreaks often follow after disasters; and these require the hospital to be both ready through their personnel capability and structural safety. He added that hospitals fail when the staff is not trained; or when infectious diseases spread due to negligence or poor ventilation.
While Dr. del Mundo said that it is more cost-efficient to construct structurally sound hospitals, existing facilities can cut on costs on their structural improvements by implementing retrofitting strategies recommended by the
WHO: a) Assess the structural safety of hospitals b) protect and train health workers c) plan for emergency response plan d) build resilient hospitals and e) adopt national policies f) protect medical equipment and supplies
To advance the objectives of safe hospitals, the Dr. del Mundo urged the participants to forge partnerships and collaboration with other agencies in the planning and construction of hospitals and health facilities.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
April14, 2009, Trader’s Hotel Manila
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Topic : Presentation of Research Results: Capacity
Assessment of Metro Manila Tertiary Hospitals in
Date
Responding to Emergencies / Disasters
: April14, 2009
Resource Person : Dr. Marilyn Go , Division Chief, DOH-HEMS
Dr. Go presented the results of the study that assessed the capacity of 25 hospitals in Metro Manila in responding to emergencies and disasters. She also gave a short background on the historical development of the study, including the methodology. Dr. Go said that they had a series of consultative discussions that lead to several workshops and writeshops for the refinement of the indicators used in the study.
She said that there were three categories of indicators; to wit:
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Structural – refers to the hospital/facility’s location; other tangible and/or physical evidences of damage/s on the facility’s basic structure/foundation (i.e., post, main beam support, etc.)
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Non-Structural
– refers to the presence and completeness of documents, plans, safety features of floors, ceilings, doors, et.c, and other physical manifestations not necessarily affecting the facility’s basic structure/foundation
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Functional – refers to the facility’s size and accessibility, available logistics, internal policies and operating guidelines and monitoring and evaluation
(Please refer to the attachment A for the complete list of indicators).
Highlights of the study show that:
Structurally:
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Majority of hospitals lie within seismic fault line, only 1 has been recommended to transfer for it sits on top of the fault line.
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For the hospitals that were built before 2001, they need any one of the following: o ASEP Peer reviews, o Structural certification, and/or o Rapid assessment of DPWH
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Cracks on the columns, walls, floors needing attentions have been identified
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Majority have complied with building standards and requirements and have the necessary documentations at hand
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Those that have no as-built plans must prepare as-found plans
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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Non-structurally:
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Non-structurally, no major findings were reported in the areas of roofs, ceilings, floors and exterior of the hospitals
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All ICUs in the hospitals were with medical equipments at par with standards
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Hospitals had varying needs in terms of the lifeline facilities o emergency power, generators and lighting o fire protection and control equipment o water sources and reservoir o back-up communications
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Majority of hospitals complied with the basic drugs and medicines as well as basic equipment in the ER
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Majority of hospitals should be provided with luminous directional signs that are located 1 foot above the floor
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Majority of hospitals have beds not properly secured and it is recommended for them to provide wheel locks
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All hospitals complied with Health Care Waste Management Program
Functionally:
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All hospitals are within the designated zones, accessible mostly by both public and private transportations
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All hospitals are accessible to the community by adequate means of transportation
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List of most available emergency equipment and medicine supplies has been identified
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Fire drills and hazard oriented drills have been regularly conducted by the hospitals
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All hospitals are secured with guards
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Almost all hospitals have identified holding and evacuation areas to accommodate surge of patients during disaster
On hospital emergency preparedness:
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Most of the hospital have their Operational Plans and HEPRRP
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Most hospitals have systems in place but the least available are the: o CBRNE, o SOPs for mental health & psychosocial support o SOPs for wastewater treatment and o SOPs for solid waste treatment
On human resource development: o Hospital staff on BLS-CPR & Standard First Aid o ER Staff on ACLS and PALS
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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Majority of hospitals have the following: o Crisis Management Committee o Organized Emergency Response team o Health Emergency Planning Group o Safety Committee o Hospital Operation Center
Dr. Go said that even the assessment tool was subjected to review. Overall, she said that the tool was able to achieve its intended objective of providing comprehensive information on the different components of a health facility that would classify it as a safe structure. She shared the following results of the review for the assessment tool:
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The tool developed captured the vital indicators of the hospital assessment
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It provided a vivid description of the hospital for administrators and planners.
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Findings can serve as guide for identification and prioritization of hospital renovations/constructions, fund allocation towards improvement of services and for policy development
For the crucial next steps, these were shared by Dr. Go:
1. Individual feedback to participating hospitals with the results of their individual hospital assessment
2. Assessment of DOH tertiary hospitals in the region
3. Refinement of the tool based on the experience in Metro Manila and the national assessment
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Explore coming up with a quantitative and summative translation of the information from the tool
 Development of a self-assessment tool that can be used for planning and monitoring
Following the presentation, Dr. Edmundo Lopez Chief of Las Piñas General
Hospital and Satellite Trauma Center raised the following questions:
1. Should hospitals be built/constructed in Metro Manila or simply be retrofitted?
2. What are the policy directions for these hospitals? (referring to those that were found to be lacking in structural safety)
3. Do we invest in them by strengthening/reinforcing their structures? Or do we simply relocate them?
Dr. Go said that the DOH is already taking the necessary steps to address these concerns.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
April14, 2009, Trader’s Hotel Manila
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Topic : Launching of Hospitals Should be Safe from
Disasters, 2 nd Edition
Date : April14, 2009
Resource Person : Arch. Prosperidad C. Luis , Chair, specialty Council on
Health, United Architects of the Philippines
Arch. Luis formally launched the 2 nd Edition of the Manual Hospitals Should
Be Safe From Disasters. The manual emphasizes the need for the physical and functional integrity of hospitals to enable them to comply with the Hyogo
Framework for Action 2005 that will make hospitals:
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To be always ready to save lives
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To continue providing essential health services
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To be the symbol of hope during critical times
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To contribute to the sense of security and well-being
Arch. Luis explained that the manual was based on the Hyogo Framework For
Action 2005, an international charter composed of member states that commit to “make hospitals safe from disasters by ensuring that all new hospitals are built with a level of resilience that strengthens their capacity to remain functional in disaster situations, and implement mitigation measures to reinforce existing health facilities, particularly those providing primary health care.”
The manual is also a response to the WHO World Disaster Reduction
Campaign on Hospitals Safe From Disaster 2008-2009 that aims to:
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raise awareness to make hospitals safe
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protect lives thru structurally resilient facilities
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ensure that facilities and services function in the aftermath of emergencies and disasters
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improve emergency management capacity
The manual was written and designed to be user-friendly, to provide health facility administrators the necessary indicators, guidelines and national policies for the construction and retrofitting of hospitals and health-related facilities. (please refer to Attachment B for complete details of the manual).
Arch. Luis pointed out the revisions on the new edition and encouraged the participants to refer to the manual for their facilities’ assessments and determination of possible requirements for retrofitting.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
April14, 2009, Trader’s Hotel Manila
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Topic : Launching of Guidelines for Health emergency
Management (Hospitals), 2 nd Edition
Date : April14, 2009
Resource Person : Dr. Carmencita A. Banatin , Director III, DOH-HEMS
DOH-HEMS Director Carmencita A. Banatin announced that the Guidelines for Health emergency Management (Hospitals), 2 nd Edition will soon be available. She said that the manual is one of the three manuals revised by the
Health Emergency Management Staff. The two others are for the Operations
Center and for the Centers for Health Development.
She added that the manual is a complementary material that hospital/health facility administrators can reference to ensure emergency preparedness capability of their respective personnel. (please refer to Attachment C).
Her presentation was a quick run-through of its contents and salient points.
Topic : Launching of the National Student Design
Competition for Hospitals Safe from Disasters
Date : April14, 2009
Resource Person : Arch. Ma. Rebecca M. Peñafiel , Director III, DOH-
NCHFD
The DOH and WHO acknowledges the need for the active participation of other partners, both from the public and private sectors. Among the private sector partner that presents the strong potential in advancing the goals of
Safe Hospitals is the academe. Through the different universities and colleges that offer architecture, awareness on the safety hospital can be heightened.
One of the means to achieve this is through the launching of a competition among architectural students who will design hospitals that are resilient to both typhoons and earthquakes. The competition is a first in the country and is not only expected to generate innovative designs from the country’s future architects, but inculcate in them the value of designing resilient and safe health infrastructures..
Arch. Peñafiel presented to the participants the mechanics and criteria of the competition. She also announced that there will be corresponding cash prizes to be won by participating schools.
Arch. Peñafiel said that the main objective of the competition was:
 To encourage architecture students to raise their awareness of the effects of disasters
 To express their knowledge of disaster resilience
 To enhance their capacity in the design of buildings where structural and functional safety are considered of primary importance
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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She also added that the contestants will design their plans based on a given situation that would address the facility’s needs to sustain and withstand possible damages from typhoons and earthquakes.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
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The launching of the Safe Hospitals program during the World Health Day
2009 celebration is expected to encourage Philippine health providers to continue their preparedness for emergencies and disasters.
Likewise, the activity is expected to enable hospital administrators and managers both from the public and private sectors to take the initiative to ensure the structural safety and functionality of their facilities.
As an initial effort, the celebration was also a call to action for all health partners and stakeholders to make stronger their alliances for health facility safety.
Part of the continuing commitment of the WHO and the DOH in achieving the goal of hospital safety is the support they have given to the publications that were launched during the activity. The Hospitals Should be Safe from
Disasters, 2 nd Edition and the Guidelines for Health emergency
Management (Hospitals), 2 nd Edition are publications that hospital administrators and health providers can use as reference materials in ensuring their facilities are structurally and functionally responsive to the emergency needs of the population especially during disasters.
World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
April14, 2009, Trader’s Hotel Manila
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World Health Day Celebration 2009 Save Lives! Make Hospitals Safe in Emergencies
April14, 2009, Trader’s Hotel Manila
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