Development of a Hospital Safety Assessment for Tsunami in the Sri Lankan Context

In the context of disasters, hospitals act as a safe place for both patients, victims and several other stakeholders. The 2004 Indian Ocean Tsunami could be identified as one of the most disastrous events which significantly impacted the coastal region in Sri Lanka. Many infrastructure and buildings were affected and destroyed due to the extremity of the event including hospitals located in the coastal line. Hence, it is necessary to assess the level of safety of existing hospitals in the coastal region in the event of a tsunami. Therefore, a hospital safety assessment tool should be developed for Tsunami under the Sri Lankan context. Since, the structural condition of buildings, functional and operational aspects, as well as the emergency management aspects, are vital to ensure the safety of hospitals under tsunami, all of these were included in the assessment tool. The most cost-effective and efficient method to obtain the level of structural safety of hospitals is the Rapid Visual Screening (RVS) method. It is because the safety level could be obtained through a sidewalk survey. In other words, the level of safety could be obtained with the RVS method through visual observations with the naked eye, without using any equipment. Also, the functional, operational and emergency management aspects could also be easily assessed through observations, reviews of documentation and structured interviews. As the developed assessment tool is expected to be used to assess the level of safety of existing hospitals, the Rapid Visual Screening (RVS) method along with the reviews of documentation and the methods of structured interviews were adapted to the assessment tool. As the initial step of developing the assessment tool, an attribute list was developed considering the available literature. For RVS structural safety assessments, the Papathoma Tsunami Vulnerability Assessment (PTVA) model and FEMA guidelines are widely used. Among these two guidelines, the PTVA model is specifically developed for tsunami while FEMA guidelines are developed for cyclones, seismic activities, floods, etc. Furthermore, the Hospital Safety Index (HSI) guide published by the World Health Organization (WHO) includes a comprehensive assessment tool related to functional, operational and emergency management categories. The developed attribute list was used to assess selected hospitals in the southern coast of Sri Lanka, in order to obtain the applicability of the developed attributes. This paper discusses the development procedure of the initial attribute list to assess the level of safety of a hospital in Sri Lanka under a Tsunami. After that, a comprehensive assessment tool could be developed through the feedback obtained through the study along with the experts’ opinions.