Hospital Safety Screening,

Solomon Islands

Honiara, Solomon Islands

2014 - 2015

Shoreline comparison 1943 and 2002, National Referral Hospital, Honiara, Solomon Islands.

In 2014, heavy rain and flooding (above along the river) sent 10,000 people to evacuation shelters in Honiara.

This assessment used the Global Hospital Safety Index, a screening tool developed by World Health Organization. WHO recently revised the Index, and we were the first to field test it in a multi-hazard environment.

We also used the Global Hospital Safety Index to assess disaster preparedness at Kathmandu hospitals, for which earthquakes are the primary hazard. That field test of the Index is described here: 

Hospital Safety Screening & Comparison with 2015 Earthquake Damage, Nepal

The National Referral Hospital in Honiara sits directly on the coast, at 1.5-2 meters above mean high tide, and close to the mouth of a river. Often over-capacity in normal times, the hospital will need to care for many more people immediately after a disaster. Will it be able to function? With our partner the World Health Organization (WHO), we evaluated site vulnerabilities, buildings, utilities, equipment, and disaster preparedness at the major hospital serving the Solomon Islands.


Cyclones pose the greatest threat, bringing storm surge, high winds, heavy rain and river flooding. A direct hit would likely destroy or severely damage most hospital buildings. The region also faces high risk of earthquakes and volcanic eruptions. A tsunami greater than two meters is likely to cause devastating damage. Sea level rise, coastal erosion and rain-induced landslides are ongoing concerns. 


We determined that the current site is not at all suitable for a critical hospital. Our recommendations:

  • Relocate the hospital to a site not exposed to coastal flooding or erosion.

  • Ensure that the new inland site is not exposed to earthquake faults, landslides or river flooding.

  • In the short term, secure items from falling in and earthquake; protect utilities from damage;  and relocate critical care wards.

  • Plan and practice evacuation and response roles with staff.


Our findings--from initial field reconniassance, local geology, maps, and satellite imagery--indicate that the site selected for the hospital’s relocation has potential karst conditions (sinkholes, caves), faults, and flooding from nearby streams. These hazards need to be further evaluated through geologic and geotechnical studies.


In January 2015  the World Health Organization noted:


We have very good news from Honiara: the Government announced the cabinet decision for relocation of the National Referral Hospital!  Big congratulations on this significant impact of your report. Another good news is that the Government also endorsed WHO-UNDP proposal on climate change and health adaptation which includes an activity on National Referral Hospital relocation and climate-proofing of health facilities.”


Now that the government of Solomon Islands has decided to move the National Referral Hospital, they are investigating a relocation site on safer and higher ground.


Project funded by World Health Organization (WHO)