• Arup provided structural engineering assessment for six hospitals in Palau, Micronesia and the Marshall Islands for the WHO safe hospitals initiative.
• The WHO have a direct interest in understanding the resilience of Hospitals in remote areas with respect to dealing with local and regional natural and humanitarian disasters.

Arup has provided the structural engineering component of the Hospital Safety Index evaluation for six hospitals in Palau, Micronesia and the Marshall Islands as part of the WHO’s Safe Hospitals Initiative.

The project saw Robert Donnan visiting hospitals at Majuro (Marshall Islands), Kosrae, Ponphei, Chuuk, Yam (all Micronesia) and Palau to do structural assessments. As well as providing a real time assessment of the hospitals’ ability to cope with an emergency, the initiative helped identify specific areas of improvement for each complex across a number of categories.

As well as providing the base structural data to feed into the other sections of the Hospital Safety Index, Arup also produced for each hospital a condition audit report that identified not only the overall condition of the hospital buildings but specific prioritised issues that required action.

Understanding the capacities, strengths and weaknesses of individual hospitals in remote Pacific Island Nations is critical in providing external support and help in the event of a major natural or man-made emergency in that locality. The WHO initiative not only allows a local hospital system to first self-assess and then build and improve capacity over time but also allows the response in the event of an emergency to be tailored to suit that region’s specific known strengths and weaknesses.

All of the hospitals assessed in this project also play a major role in providing health services to remote parts of the island they are located or more typically other outlying islands within their immediate vicinity. In some cases this results in the main hospital also mobilising a vessel for connectivity, small remote clinics that can provide some front line services and first aid and radio communication systems to allow linkage and reporting across the region. Some of the hospitals support an area of thousands of square kilometres but generally a small but very scattered population.

The majority of the hospitals were constructed over 40 years ago and although well designed and well-constructed have not necessarily been well maintained since then.

The structural assessment of these hospitals highlighted the tremendous challenges that these very remote Pacific Island Nations have in providing an acceptable level of healthcare to their people
Robert Donnan, Associate Principal Arup, Cairns

As a short comment, I can report back to you that as WHO we have been very satisfied with Arup’s contribution to the Hospital Safety Index assessment for the Majuro, Kosrae, Ponphei, Chuuk, Yam and Palau Hospitals. In particular, the recommendations for the 4 hospitals in FSM have been the basis for the planning and budget allocation of MoH to retrofit these hospitals with the most urgent measures that came out of the Safe Hospital assessments reports. This is a very good example of technical assistance that support MoH to take decision and that has an impact in terms of strengthening local health systems disasters resilience.
Dr Nevio Zagaria, WHO