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Hospitals are considered critical service units of a society that need to operate before,
during, and after disasters. The Ministry of Health of Sri Lanka has embraced the “Safe
Hospitals” Initiative promoted by the World Health Organization (WHO), as a
strategic priority for health sector Disaster Management to strengthen the resilience of
the hospitals. WHO has developed a toolkit for the assessment of the safety of hospitals
including structural, non-structural, and functional aspects. This toolkit consists of four
modules that are; hazard identification, structural safety, non – structural safety, and
emergency and disaster management. A review of this toolkit has pointed out the need
for major alterations to the structural safety module of the Safe Hospital Toolkit to Sri
Lanka since the Sri Lankan disaster profile is quite different from that of the Latin
American countries in which the toolkit was developed; where earthquakes and
cyclones are predominate. The objective of this assessment was to develop a toolkit to
assess the structural safety of hospitals in Sri Lanka addressing the structural
vulnerability/robustness of buildings considering natural hazards; high winds, floods,
tsunamis, and landslides. Accordingly, a draft Structural Safety of Hospitals
assessment Sri Lanka (draft SSH – SL) has been developed based on the Safe Hospital
Toolkit and the available Sri Lankan guidelines for hazard resilient constructions.
Then, the draft SSH – SL has been used in a pilot study to identify its limitations, on
two hospitals based on their functionality, namely the District General Hospital
Gampaha and the Teaching Hospital, Kegalle. To further develop the SSH - SL, field
data of another pilot study conducted on six hospitals on the southern coast are used
along with a thorough literature review. Moreover, expert surveys were conducted to
further improve the toolkit and to obtain the weights using the Analytical Hierarchy
Process (AHP), for all the criteria in the SSH – SL, and a Structural Robustness Index
(SRI) is defined. Finally, the developed tool under tsunamis is checked for
applicability based on the data obtained from the second pilot study and is validated
by comparing the actual damage occurred in 2004 Indian Ocean Tsunami with the
obtained SRI scores. However, the developed tool for other assessments require
validation through more case studies. According to the relative weights obtained
through AHP, two main attributes; construction material and the foundation system were found to be significantly important. The assessments of tsunamis and floods share
the same building attributes with different weights; the attributes of the lateral load
resisting system and the number of stories get a higher weight under the tsunamis
compared to floods, as the impact loads applied by the tsunamis are higher than that
of the floods. Considering the SRI scores, it was found that the median score for the
general assessment is 3 whereas it is 2.33 for all the other assessments. This gives a
clear idea of the robustness of buildings as the SRIs above the median score are tend
to be robust and the SRIs below the median tend to be vulnerable. The case study
carried out focussing on the assessment developed for tsunamis suggests that the
Structural Robustness Index (SRI) method is a more nuanced and improved method
for assessing the structural robustness compared to the PTVA method. It is highlighted
that the SRI method identifies structures that are above the median level in terms of
structural robustness than that of the PTVA method. As far as the intra-hospital
variation is concerned, the SRI variation mostly depends on the building attributes
such as the number of storeys and the construction material. It is also identified that
there is a coupling effect between building attributes such as the construction material
and the number of storeys as the buildings with a higher number of storeys are also
tend to be made of reinforced concrete frames whereas the single storey buildings are
made of masonry. The inter-hospital variation of SRIs mostly depends on the
surrounding attributes as they change with the geographical location. These results are
valid for the buildings up to four storeys including unreinforced masonry, reinforced
concrete structures with masonry infills, and reinforced concrete framed structures that
were assessed during the field survey. The SSH - SL could be further improved by
incorporating the level of exposure and functional attributes and emergency and
disaster management attributes to develop a comprehensive risk index, which is
beneficial for the disaster management decision-making stage of hospitals. |
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