Resilient Health Systems are Essential for Safer Communities

acharya87
1 day ago
4 min read

Updated: 21 hours ago

Today marks 16 years since the devastating M7.0 earthquake in Haiti, one of the deadliest disasters in the past 50 years. That event destroyed 60% of hospitals in the affected area. In the aftermath, many survivors of the violent shaking were left without access to medical care, contributing to the unnecessary loss of life and excruciating suffering.

More than a month after the earthquake, I visited a hospital in Port-au-Prince. The facility’s basic functions had yet to be restored, and all patients—including those with life-threatening conditions—were being treated outdoors without appropriate care. That experience had a profound impact on me and underscored the critical need for disaster-resilient health systems.

Disasters can wreak havoc on health systems, especially those that are fragile to begin with. I’m proud of GHI’s work for the past 20+ years to help enable continuous delivery of medical care when it is needed most—during and after disasters. Below is an overview by Dr. Janise Rodgers, who has led our team in much of this important work.

Veronica Cedillos, President & CEO

The systems that provide healthcare services to communities are networks of institutions, infrastructure, and people that are exposed to hazards along with the communities they serve.

Health facilities are a critical lifeline. When disasters strike, health systems may be overwhelmed, leading to preventable loss of life, disruption of essential services, and long-term setbacks in public health outcomes. (Photos: Gefthé Dévilmé, GHI; Canva stock)

Past disasters have demonstrated the dire consequences of health systems that were not designed and prepared for hazard events. The loss of 60% of the hospitals in the affected area in the 2010 Haiti earthquake and destruction of over 40% of small community health facilities in the districts most affected by the 2015 Nepal earthquake¹are poignant examples of the vital importance of investing in resilient facilities. Resilience goes beyond buildings and infrastructure. Medical personnel as well as engineering and support staff must also be trained to function in a disaster situation.

What does it mean to have resilient health systems?

A health system’s ability to deliver care can be affected even if buildings remain structurally sound. In hospitals in particular, power, water, oxygen, sanitation, and communication systems might fail; equipment and supplies might be destroyed or inaccessible; staff may be injured. Solutions involve adding safety, redundancy and backup systems. Small facilities such as clinics may face damage and shortage of utilities, staff and supplies.

A city or community’s health system—and the community itself—may need to function in isolation. Access roads in mountain regions may be blocked by landslides after earthquakes or hurricanes. Small island states may have few supply chain options. Sufficient supplies and communication are vital.

Personnel need to be trained to anticipate and manage disruptions that could impair healthcare services. Strategies are needed to manage a surge in patients, keep staff safe and well, and communicate. Through preparedness planning and drills, staff can gain confidence to face a crisis.

A disaster-resilient hospital relies on integrated facilities, planning and training, including hazard-resistant buildings, protected equipment, backup utilities, prepared staff, and sufficient supplies. (Graphic: GHI)

How has GHI contributed?

Our work on disaster resilience of health systems has involved over 25 projects across 10+ countries. Our efforts span facility assessments, mitigation action planning, emergency planning and exercises, policy and regulatory development, as well as training and capacity building.

Our contributions focus in the following key areas:

Keeping buildings safe by identifying facility vulnerabilities and developing strategies to address them. Our work has included 43 hospital assessments, and in some cases included developing retrofit solutions. Many efforts included technical training for local professionals.
Supporting facility functionality by developing customized tools and targeted training. Examples include our manual on how to secure building elements and equipment and our customization of the World Health Organization’s Hospital Safety Index for Nepal and Myanmar; both focus on utilities and equipment. GHI, along with our sister organization GeoHazards Society in India, has trained over 4,500 professionals to assess facilities and keep them functional.
Helping healthcare personnel be disaster-ready through preparedness planning and drills that embed disaster safety practices in medical teams and surrounding communities. For example, we co-developed and tested disaster management plans for major hospitals in Bhutan and for district hospitals in a remote, hilly state in India.
Integrating health system resilience in national-level efforts through policy. In Bhutan, for example, we co-developed a National Action Plan for Hospital Safety and an update to the Health Emergency and Disaster Contingency Plan.

Across our work, we have consistently treated health systems not as a standalone sector, but as an integral part of broader resilience efforts—especially in co-developing disaster scenarios and scenario-based action plans. This progress underscores GHI’s comprehensive and long-term approach to enabling community access to critical medical care during and after disasters.

Full scale drill in Bhutan with students acting as patients provided a valuable exercise for regional hospital staff after completing a week of planning. (Photos: Hari Kumar, GHI)

What is coming next?

We are thrilled about our recently launched two-year project, Strengthening Haiti’s Health Facilities for Disaster Resilience funded by the Coalition for Disaster Resilient Infrastructure's Infrastructure Resilience Accelerator Fund (CDRI-IRAF) and conducted in partnership with Haiti’s health ministry. This project aims to strengthen Haiti’s health infrastructure to support continuous medical care during and after emergencies and hazard events. Key activities include assessing health facilities, developing resilience action plans, and improving backup systems for resilience. The project will directly benefit an estimated 450,000 people by improving disaster resilience in six health facilities, with a focus on continuous access to critical services, especially for vulnerable groups.

Dr. Garmalia Mentor-William, GHI Haiti Representative serving as the project's Field Team Lead & Strategic Focal Point, reflects on her personal experience in the 2010 earthquake.

Ultimately, prepared and resilient health systems are essential for safer, healthier communities. We are excited to continue working with healthcare professionals and the natural hazards community to increase the resilience of these vital systems.

Best Regards,