On the occasion of the World Health Day, WHO has asked for focusing attention on the large numbers of lives that can be saved during earthquakes, floods, conflicts and other emergencies through better design and construction of health facilities and by preparing and training health staff.

WHO is recommending six core actions that governments, public health authorities and hospital managers can undertake to make their health facilities safe during emergencies. These include training health workers, designing and building safe hospitals, retrofitting existing health facilities to make them more resilient and ensuring staff and supplies are secure.

“With our world threatened by the harmful effects of climate change, more frequent extreme weather events and armed conflicts, it is crucial that we all do more to ensure that health care is available at all times to our citizens, before, during, or after a disaster,” said WHO Director-General Dr Margaret Chan.

The six steps that governments, public health authorities and others who operate hospitals and health care facilities can take are to:

1. assess the safety of hospitals;
2. protect and train health workers for emergencies;
3. plan for emergency response;
4. design and build resilient hospitals;
5. adopt national policies and programmes for safe hospitals; and
6. protect equipment, medicines and supplies.

Too often, health facilities are the first casualties of emergencies. This means that health workers are killed and wounded, that services are not available to treat survivors and that large investments of valuable health funding in health facility construction and equipment are squandered.

World Health Day is being launched in China this year, where an earthquake in May 2008 killed over 87000 people and destroyed more than 11000 health care facilities.

Relatively inexpensive investments in infrastructure can save lives during disasters. Some countries have taken action to improve safety of health facility, and their preparedness and response to emergencies.

• In earthquake-prone countries such as Japan, Pakistan and Peru, hospitals have been built using efficient building standards that cause little additional costs and can withstand earthquakes.
• In Mexico, a Hospital Safety Index has been applied to over 100 health facilities, enabling authorities to determine which facilities are safe and which require improvements.
• In Bangladesh, which regularly is battered by strong cyclones, the government has invested in safely-built facilities for health, education, and other services that shelter and protect communities. These can withstand flooding, and save thousands of lives, as when Cyclone Sidr struck in November 2007.

In areas affected by conflicts, hospitals and clinics should be allowed to function by all parties in line with international humanitarian law.

Infectious disease outbreaks are another form of public health emergency that staff should be trained for.

WHO is urging all ministries of health to review the safety of existing health facilities and to ensure that any new facilities are built with safety in mind. Practical and effective low-cost measures such as protecting equipment, developing emergency preparedness plans and training staff can help make health facilities safer, better prepared and more functional in emergencies

Dr Eric Laroche, WHO Assistant Director-General for Health Action in Crises, said untold lives can be saved if health systems were better protected from emergencies. "The most expensive health facility is the one that fails, both in human and financial terms," Dr Laroche said. "We know we can do more to prevent our hospitals and clinics falling victim to emergencies. The time has come for action."