|Pakistan: Rebuilding better through compulsory risk reduction designs|
In 2005, a 7.6 magnitude earthquake struck a wide region of South Asia, affecting parts of Afghanistan, India and northern Pakistan. More than 73,000 people lost their lives and at least 150,000 others were injured. Almost half of the operating health facilities were completely destroyed and demand for emergency medical care was overwhelming This good practice example discusses 3 important lessons learned from the earthquake.
The event that prompted action
A 7.6 magnitude earthquake struck a wide region of South Asia on the morning of 8 October 2005, affecting parts of Afghanistan, India and northern Pakistan. The epicentre of the earthquake was located 95 km northeast of the Pakistani capital, Islamabad. In a matter of seconds, 85% of the infrastructure in towns such as Balakot was destroyed. Other cities such as the Kashmiri capital, Muzaffarabad, lost between 40% to 50%of its buildings. Strong aftershocks threatened structures already damaged by the initial quake.
More than 73,000 people lost their lives and at least 150,000 others were injured. Demand for emergency medical care was overwhelming. The earthquake left an estimated 3.2 million people homeless.
Could lives have been saved?
If vulnerability assessments had been systematically carried out, if hospital disaster plans had been better prepared, tested and widely disseminated, and if health staff was better prepared in areas such as mass casualty management, many lives might have been saved and health facilities might have been able to function better, in spite of damage and the impact on health staff. The town of Balakot, which saw 85% of its infrastructure destroyed, including the hospital, is an example. In retrospect, it was learned that the town itself was built on unstable (unsafe) terrain. After the earthquake, the Government of Pakistan declared a 600-hectare area a “red zone”, meaning that no construction was allowed. Had earthquake vulnerability assessments been conducted beforehand, the risk would have been known and the existing hospital could have been retrofitted. In other instances, if proper triage systems had been in place, unnecessary evacuations — which separated many families already in a chaotic situation, forcing them to travel significant distances to search for injured relatives — could have been avoided.
Rebuilding health facilities became a priority. To help ensure that a future disaster of this magnitude would not cause the same devastation, the Government of Pakistan introduced a series of disaster risk reduction and preparedness measures at local, provincial and national levels. One of these was the creation of the Earthquake Reconstruction and Rehabilitation Authority (ERRA). Under its programme “Knowledge and Capacity Building for Disaster Resilience: Earthquake-Affected Region in Northern Pakistan” UN/ISDR assisted ERRA in designing earthquake resistant buildings. Many of the designs, technologies and techniques introduced by the Citizen’s Foundation (a UN/ISDR implementing partner) were accepted and supported by ERRA as a standard to be followed by others. The standards were applicable and are being followed by many for housings as well as critical infrastructure (schools, health facilities, mosques etc). The program was complemented comprehensively by awareness raising (through knowledge centres at grassroots level) and training programs for home owners, craftspeople, village elders, and line departments of the government. The training included guidance on ensuring that heavy equipments or furniture such as racks/cupboards are fixed properly so that in case of earthquake they do not fall and cause damages. In the specific case of health facilities, ERRA looked at the geographical and population distribution of the health facilities that were scheduled to be rebuilt and concluded it was unnecessary to rebuild all pre-existing facilities. Rather, they chose to build back better by providing compulsory earthquake risk reduction designs for the 237 new basic health units, district and tehsil (sub-district) headquarter hospitals and rural health centres that are being rebuilt (download designs). Another 105 health facilities have been or will be repaired using safety and seismic retrofitting.
The South Asia earthquake of 2005, like all disasters that cause massive damage and great human losses, created a real window of opportunity in terms of raising the awareness of national authorities on the need for disaster risk reduction in the health sector. In Pakistan, members of civil society also demanded that national, regional and local disaster mitigation and management strategies were developed based on lessons learned. The lessons learned include:
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