Our recent experience makes it imperative to review safety plans for Puerto Rico's hospital facilities and update the plans to properly respond to earthquakes of greater magnitude than the one recorded on January 7, 2020.
Public hospitals, including Medical Center facilities, specialized in trauma, must complete - in the short term - thorough inspections that document in detail their structural conditions. It will be also important to consider recommendations by engineers on strengthening buildings or planning new and more resilient constructions in case of an earthquake.
A group of physicians recently expressed their concerns about the high-risk projections documented in a study conducted by the University of Puerto Rico in 2015, after evaluating facilities such as the Trauma Hospital and other buildings of the Río Piedras Medical Center. Authorities must address these concerns by health professionals as part of the efforts to reduce our vulnerabilities before natural phenomena.
Some doctors argue that the issue must be a priority on the reconstruction agenda implemented since the 2017 hurricanes, because most hospitals on the island were built in the past century and many do not respond to building codes that incorporate base insulators that prevent vertical displacement in the event of strong earthquakes, among other measures.
The effort by a group of experts to draft a document to develop a comprehensive trauma management plan in the event of a severe seismic emergency has also been a wise step. The government has to consider this document to determine whether it can be expanded and validated to ensure maximum safety for the population.
According to preliminary data from the Emergency Management and Disaster Administration Bureau (NMEAD), the January 7 earthquake killed one person and destroyed 126 houses and causing major damage to another 598 residences, mainly in the southwestern area of the island. Fortunately, there were no citizens injured or seriously injured.
The experience in other jurisdictions, however, requires that safety and medical response protocols be implemented in line with World Health Organization recommendations for earthquake emergencies. These recommendations by the international organization must be incorporated into the plans the government is reviewing. The private sector, which operates numerous hospitals and clinics on the island, must contribute to this effort. WHO recommends establishing which hospital facilities should be a priority in order to carry out vulnerability studies and adopt disaster impact reduction measures. It also suggests non-structural disaster mitigation or intervention measures in all maintenance, inspection, restructuring and improvement plans for existing hospitals.
On the island, doctors have proposed to provide additional training for nurses and other health professionals so that they can better support the limited number of trauma physicians available. These specialists will be key to assist patients in the event of a major seismic emergency when response within the first 24 hours is critical to stabilizing multiple injuries that are common in such emergencies.
Groups of doctors, in coordination with the National Guard and NMEAD, have recently reviewed contingency plans that include requests for medical support from other countries and setting up of hospitals under tents with orthopedists and surgeons, among other resources.
All these initiatives are necessary, but they must be part of a comprehensive plan to strengthen hospital facilities and comprehensively update response plans to avoid improvisation in the event of a significant emergency caused by extreme natural phenomena, such as earthquakes or hurricanes.