When cyclones devastate a city, when homes collapse in a sudden earthquake, the most urgent need is medical attention. But a hospital is not necessarily a place of greater safety. On Wednesday – which has been declared an international day for disaster reduction – a conference in London will tackle an overlooked issue: how to make hospitals safer.
In the Gujarat earthquake of 2001, a total of 3,812 hospitals, clinics and other health facilities were reduced to piles of rubble: patients died, and medical staff with them. Seven years later, in the Wenchuan earthquake that levelled cities in Sichuan, China, more than 11,000 health centres were also seriously damaged or completely destroyed. The tsunami that claimed an estimated 250,000 lives on Boxing Day 2004 also damaged or swept away almost two-thirds of the hospitals and clinics in the northern Aceh province on Indonesia. Cyclone Nargis on 2008 damaged more than half of all the treatment centres in its path as it swept across Burma, and destroyed one hospital in five. In January 2005, at a meeting organised under the UN's International Strategy for Disaster Risk Reduction, at Hyogo, Japan, 168 nations resolved to make their cities and towns – and in particular, their schools and hospitals – safer places by imposing and enforcing higher building standards.
Humans tend to regard natural disasters as terrible things that always happen to someone else. This calculation of probabilities that makes it easier, both in the developing and the developed world, for contractors to cut corners and public servants to augment incomes by looking the other way. But such logic is cruelly expensive. An estimated 6,000 schools collapsed in the 2005 Kashmir earthquake, killing 17,000 children and 853 teachers; thousands of schools collapsed and many thousands of students perished in Sichuan in China last year.
Storms and earthquakes do not kill people: buildings do the killing. More than half of the world's population is now urban, the numbers at risk are greater than ever, and so is the need for safer schools and hospitals. Floods and windstorms arrive with little warning; earthquakes are not predictable. But in 2008, a total of 321 natural disasters claimed more than 235,000 lives and cost the world an estimated $181bn, and 2008 was not such a bad year: on average, 398 events have met the UN criteria for a natural disaster each year during this decade. Wednesday will be marked in most capitals by declarations of good intention, but the odds are high that it will be marked in at least one of them by sudden, widespread death and suffering, because natural catastrophe is now an everyday event.