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Hospital Safety Challenges  During Natural Disasters
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Hospital Safety Challenges During Natural Disasters

O ver 400 hospitals across the country were inspected this year for infrastructural safety during disasters, said Ali Ardalan, director of the Health Ministry’s Disaster Risk Management Office.
“Around 421 hospitals were assessed since the beginning of the current Iranian year (March 21) using the FSHI tool,” he said, ISNA reported.
Hospital Safety Index (HSI) is an index for checking hospital resilience and durability developed by the WHO in line with the 2008-2009 UNISDR-WHO Global Campaign on Hospital Safety from Disasters.
Accordingly, the Health Ministry initiated a national program in collaboration with Tehran University of Medical Sciences to integrate HSI into the health system. As a first step, the HSI was adapted to meet local standards and translated into Farsi (FHSI).
Hospital safety from disasters is a challenge to both developing and developed countries. Their vulnerability during disasters is greater because of their complex structural, non-structural, and functional components, high level of occupancy; and expensive equipment.
Iran is prone to natural calamities, particularly earthquakes. With nearly 1,000 hospitals, the adverse impact of disasters on medical facilities is enormous as seen in the Bam earthquake in 2003 when almost all public and private hospitals collapsed. In the 2005 quake in Zarand in Kerman Province, the main district hospital became non-functional for about six hours due to power cuts and other damages.
In the East Azarbaijan earthquake in 2012, district hospitals almost collapsed, including one that had opened just a year earlier. A fire in Tehran’s Arg Mosque in 2006 saw more than 100 cases of burn injuries, challenging the capital’s hospital capacity and ability to manage victims of disasters.
During contingencies, hospitals must be able to continue functioning without disruption and attend to the injured.

 Endorsement
In 2012, FHSI was officially endorsed by the Health Ministry and all hospitals were asked to assess their safety using the index. By September 2013, nearly 224 hospitals had conducted assessments.
The results were used to advocate the importance of hospital safety and it led to the 2014 Hospitals Accreditation Protocol, ratified by the ministry, using the FHSI yardstick as annual accreditation criterion.
“The index evaluates hospitals’ general preparedness including functional capacity, structural safety, non-structural safety, overall safety, and safety levels,” said Ardalan.
“The index increased from 34% in 2013 to 43% in 2015 indicating a significant improvement.”
Ardalan stressed that more needs to be done to ensure maximum safety of all hospitals. The ministry intends to assess all hospitals as per the FSHI index by the year-end (March 20, 2016).
The Health Ministry also has an evaluation system for crisis management. The three-pronged evaluation system assesses safety index in hospitals, safety index for health and rescue units, and safety index for Iranian households.
“The safety index for households was 8.5% in 2014, and reached 9.3% this year indicating an increasing trend, although we still have a long way to go,” Ardalan noted.
The ministry will soon prepare households for disasters. In the past two years, the plan covered 10 counties and 100,000 households on a trial run. It is integrated into the ministry’s general plans this year to cover over 400,000 households in cooperation with the Iranian Red Crescent Society.

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