A survey of flood disaster preparedness among hospitals in the central region of Thailand

Abstract

Background

In 2011, Thailand was affected by the one of the worst flood disasters in recent times. Hospitals in Thailand were faced with the challenge of managing the health impacts from this natural disaster. The purpose of this study was to assess flood disaster preparedness among hospitals in the central region of Thailand.

Methods

A survey questionnaire was given to twenty-seven key people responsible for hospital disaster preparedness that experienced disruptions to health services (severely, moderately and slightly) during the flood disaster in 2011 in the central region of Thailand.

Results

Of the twenty-four participating hospitals, not one had satisfied the standards in all the dimensions of flood disaster preparedness. All respondent hospitals were deficiently prepared with regard to surge capacity, the management of healthcare services and the management of the supporting systems. The availability of supplies and equipment were found to be in place but preparations were found to be inadequate in organizing staff at all participating hospitals. Trained staff members regarding disaster response were reported to be present in all respondent hospitals. Hospitals that experienced slightly disruptions to their health services did not elect to do any exercises to meet the set standards. None of the hospitals that experienced slightly disruptions to their health services performed any evaluation and improvement in terms of disaster preparedness.

Conclusions

Many hospitals were not up to standard in terms of disaster preparedness. Hospitals should prioritize disaster preparedness to fulfill their responsibility during crisis situations and improve their flood disaster preparedness.

Introduction

The world disasters report of 2015 revealed that in the past 10 years (2005–2014), flood disasters were the most frequently reported types of natural disasters worldwide at 1751 (45.97%) with about 59,092 people killed, 866,417 people affected and economic losses amounting to 342,836 million USD [1]. The occurrence of flood disasters around the world has increased in severity and economic cost. Specifically in Thailand, the worst flood disaster in at least five decades occurred in 2011 with 1085 deaths and affecting 4,103,322 residents. The economic loss was estimated by the World Bank to be approximately 45.7 billion USD, which means that this flood was the fourth most expensive natural disaster in recent history [2], [3]. The central region of Thailand was particularly affected by this catastrophe.

There are several reasons why the central region of Thailand is highly vulnerable to flooding [4], [5] including the geography of the region, the fact that it is a large plain area, and the extensive amount of run-off of water that originates from the highlands of Northern Thailand every year. In addition, rising tides, under-sufficient dam capacity and poorly organized city expansion plans have contributed to the problem. In the coming years, flood disasters are predicted to rise in frequency and magnitude. The central region of Thailand, therefore, remains the most vulnerable to future flooding, which means that people of Thailand will be more exposed to the consequences of flood disasters. As a result, there is a serious need for health facilities to develop effective plans-of-action in order to handle certain crisis situations going forward.

The common health problems and the causes of mortality and morbidity with regard to flooding situations in Thailand include drowning, trauma injury, electrical injury, communicable diseases (waterborne and vector-borne diseases, communicable diseases associated with crowding, other communicable diseases associated with floods), and animal bites [6], [7]. The state of the mental health of the people has also been considerably affected, resulting in stress, panic, anxiety, depression, and an increased risk of suicide [8].

Flood disasters also have an impact on the structure and function of hospitals. Severe damage to hospitals has been reported following the flood disaster in Thailand in 2011. Five hundred and sixty-one hospitals under the jurisdiction of the Ministry of Public Health (MOPH) were damaged by floods and most of the affected hospitals were located in the central region of Thailand. The losses were estimated to be about 340 million Baht (over 1 million USD) [9]. The infrastructure of the hospitals was seriously damaged, which included service units, fences, and official residences. Breakdowns in road networks led to the disruption of supply chains, the unavailability of medical equipment, and shortages of supplies and medical staff [10]. All of these problems have led to a decrease in the capacity of hospitals, which has had an impact on the health conditions of flood disaster victims.

Regardless, hospitals need to continue to provide routine health care services to their patients and expand their facilities to meet the immediate healthcare demands of flood disaster victims, even while their facilities are damaged or their capabilities ability to offer services has been disrupted. Therefore, it is vital that hospitals remain operational in a manner that extends beyond their normal capacity to sustain uninterrupted medical services for flood-affected communities when these services are needed the most [11], [12]. Thus, the coping capacity of hospitals in regard to flood disaster challenges needs to be developed in an effective way. Regardless of whether or not hospitals have adequate capacity in normal situations, most of them cannot effectively manage the more urgent demands that arise in immediate situations by merely relying on routine procedures or resources; thus, hospital disaster preparation is needed to enhance the coping capacity of the hospitals for the adverse consequences of flood disasters.

Preparedness for disasters has been in place in Thailand for some time as the country has a long history of having to endure various types of natural disasters. For example, the flooding in 2001–2002 and the 2004 tsunami forced the Thai government to create several mechanisms to handle emergency situations. Establishing the National Disaster Prevention and Mitigation Committee, developing and implementing the National Disaster Prevention and Mitigation Plan across the country, assigning responsible organizations and revising associated laws and policies of enforcement to ensure effective responses during disasters have all been put in place. The major Thai flood disaster in 2011 has proven that the previous level of preparedness was insufficient; hospitals were not immune to disasters and problems and as a result, hospitals struggled to provide care for flood disaster victims [10]. Thus, efforts need to be made to improve hospitals and better prepare them for future flood disasters. After the flood disaster in 2011, improved flood disaster preparedness has been gradually implemented. Understanding the current status of hospitals’ flood disaster preparedness is essential for designing more effective responses for better readiness. Exploring hospital flood disaster preparedness is vital for assessing and evaluating their synchronized performances.

An in-depth assessment of the disaster preparedness of hospitals, especially flood disasters in various settings, is limited [13], [14]. Hospital flood disaster preparedness assessment in Thailand has only been done in one study [15] but it was conducted two months after the floods. It was not an accurate representation of the current level of preparedness. The authors highlighted that their research would be the starting point of improvement for disaster preparedness for flooding. Yet, there is no research on the current level of preparedness in hospitals in the central region of Thailand.

Thus, the objective of this study was to assess flood disaster preparedness among hospitals in the central region of Thailand. It is not known whether hospitals in the central region of Thailand are sufficiently prepared for future flood disasters. The study findings will illustrate the current status of hospital flood disaster preparedness so as to understand and identify the areas of improvement needed for managing the impacts of the next flood disaster.