1. EarthquakesEarthquakes
- significant issues -- significant issues -
David AlexanderDavid Alexander

2. Construction failureConstruction failure poses theposes the
greatest threat to life ingreatest threat to life in
earthquakesearthquakes

3. Structural integrityStructural integrity::
a building's physical adequacya building's physical adequacy
for its intended purposefor its intended purpose
FailureFailure: total or partial: total or partial
collapse, or the destruction orcollapse, or the destruction or
non-functionality of a buildingnon-functionality of a building..

4. Seismic damage to buildings
is a function of:-
• seismic energy expenditure:
magnitude
duration of strong motion
maximum acceleration
• distance from epicentre
• surface geology
(soft sediments amplify waves)
• effect of construction type
• regularity of building form
• state of maintenance of building.

8. In the Tangshan (China) earthquakeIn the Tangshan (China) earthquake
of July 1976 (magnitude 7.6),of July 1976 (magnitude 7.6),
of 352 multi-storey buildings:of 352 multi-storey buildings:
• 44 (1%)(1%) maintained theirmaintained their
structural integritystructural integrity
• 177177 (50%)(50%) collapsed completelycollapsed completely
• 8585 (24%)(24%) collapsed partiallycollapsed partially
• 8686 (25%)(25%) were severely damagedwere severely damaged

9. Knowledge must be gained of how to:-
• buttress buildings temporarily
• repair buildings permanently
• design and construct
buildings antiseismically.

11. Antiseismic design utilizes:-
• experience of a building's
seismic performance
• hypotheses about a building's
seismic response
• design techniques to combat
weaknesses in buildings
induced by earthquakes.

12. The largest urban seismic riskThe largest urban seismic risk
is in Istanbul and Tehranis in Istanbul and Tehran
Major earthquakes represent an enormous
urban search-and-rescue (USAR) challenge

13. The international relief system is
hugely expensive and inefficient
$1,000,000 per life saved!

14. • in the 20th century 46 lethal
earthquakes caused 128,000 deaths
• in the 20th century 46 lethal
earthquakes caused 128,000 deaths
• a damaging quake once in 24-56 months• a damaging quake once in 24-56 months
• 70%70% of the population lives inof the population lives in
municipalities classified seismic;municipalities classified seismic;
40%40% in 2,965 highly seismic onesin 2,965 highly seismic ones
• 70%70% of the population lives inof the population lives in
municipalities classified seismic;municipalities classified seismic;
40%40% in 2,965 highly seismic onesin 2,965 highly seismic ones
• greatest risk is in thegreatest risk is in the
22,000 historical town centres22,000 historical town centres
• greatest risk is in thegreatest risk is in the
22,000 historical town centres22,000 historical town centres
• 35.3%35.3% of homes in earthquake zonesof homes in earthquake zones
are anti-seismically constructedare anti-seismically constructed..
• 35.3%35.3% of homes in earthquake zonesof homes in earthquake zones
are anti-seismically constructedare anti-seismically constructed..
In Italy...In Italy...

17. VICTIM
UNINJURED INJURED
HEALTHY INFECTED
WORSENING
OF CONDITION
IMPROVEMENT
OF CONDITION
HEALTHY
IMPROVEMENT
OF CONDITION
DISEASES INJURIES
Public health measures
Search and rescue
Medical assistance
Medical aid
Mortuarial
and funeral
services
WORSENING
OF CONDITION
DEATH
DISASTER

18. No damage
to buildings
Damage
to buildings
Injuries
Emergency room
injuries
Hospital
admissions
Source: Linda Bourque, UCLA

19. In the El Salvador earthquake
of 1986 hospitals collapsedhospitals collapsed.
In the El Salvador earthquake
of 1986 hospitals collapsedhospitals collapsed.
In the El Salvador earthquake
of 2001 hospitals collapsedhospitals collapsed.
In the El Salvador earthquake
of 2001 hospitals collapsedhospitals collapsed.
In the Bam, Iran, earthquake
of 2003 hospitals collapsedhospitals collapsed.
In the Bam, Iran, earthquake
of 2003 hospitals collapsedhospitals collapsed.
In the Italian Irpinia-Basilicata
earthquake of 1980 hospitals collapsedhospitals collapsed.
In the Italian Irpinia-Basilicata
earthquake of 1980 hospitals collapsedhospitals collapsed.
....haven't we learnt anything at all?

20. "At Olive View Medical Center, two buildings"At Olive View Medical Center, two buildings
collapsed in 1971, and three people died,collapsed in 1971, and three people died,
including two patients on life-support systemsincluding two patients on life-support systems
that failed when auxiliary generators did notthat failed when auxiliary generators did not
start. The third was an ambulance driver whostart. The third was an ambulance driver who
was crushed by a falling wall. Olive View waswas crushed by a falling wall. Olive View was
an 888-bed hospital then. It had only beenan 888-bed hospital then. It had only been
open a month when the quake hit. Because ofopen a month when the quake hit. Because of
extensive damage, the hospital was rebuilt,extensive damage, the hospital was rebuilt,
with attention to strengthening it against anywith attention to strengthening it against any
future quake. But it was much smaller. Now itfuture quake. But it was much smaller. Now it
has a capacity of 377 patients."has a capacity of 377 patients."
[Sylmar, California, history file]

21. Of the 58 fatalities caused by building damage, 50 occurred
in hospitals. The worst damage to medical facilities
occurred at the Veterans Administration Hospital in Sylmar
where two large buildings collapsed. Even though the
hospital site was right on the edge of the heavily urbanized
San Fernando Valley, it took one hour and 22 minutes
before a fire department helicopter happened to spot the
collapses and send help. The reason for such a delay? The
phones didn’t work, the hospital’s radio was in one of the
collapsed buildings, and the first message orally delivered
by a hospital staff member to a nearby government facility
was confused with an already received report of damage to
a different nearby hospital.
[Reitherman 2004]

26. Seismic hazards to hospitals:-
• loss ofloss of structural integritystructural integrity
and building functionalityand building functionality
• seismically-inducedseismically-induced floodingflooding,,
landsliding and subsidencelandsliding and subsidence
• loss of trainedloss of trained personnelpersonnel
• loss of medical andloss of medical and surgical capacitysurgical capacity
• loss ofloss of suppliessupplies (including utilities)(including utilities)
and failure of supply chainsand failure of supply chains
• inaccessibilityinaccessibility..

27. UnaccaptableUnaccaptable
performanceperformance
UnaccaptableUnaccaptable
performanceperformance
UnaccaptableUnaccaptable
performanceperformance
FullyFully
operationaloperational
OperationalOperational LifeLife
safesafe
NearNear
collapsecollapse CollapseCollapse
RareRare
60%g60%g
VeryVery
rarerare
80%g80%g
Seismic design levelSeismic design level
HospitalsHospitals

28. Capacity:Capacity:
• beds (beds (expandableexpandable))• beds (beds (expandableexpandable))
• surgical and curative (surgical and curative (fixedfixed oror
diminisheddiminished in the short term)in the short term)..
• surgical and curative (surgical and curative (fixedfixed oror
diminisheddiminished in the short term)in the short term)..

29. ResilienceResilienceResilienceResilience
• ensuringensuring continuitycontinuity ofof
services and medical suppliesservices and medical supplies
• ensuringensuring continuitycontinuity ofof
services and medical suppliesservices and medical supplies
• ability to cope with veryability to cope with very
largelarge surges in demandsurges in demand
• ability to cope with veryability to cope with very
largelarge surges in demandsurges in demand
• protectingprotecting personnelpersonnel andand
their immediate familiestheir immediate families
• protectingprotecting personnelpersonnel andand
their immediate familiestheir immediate families
• protectingprotecting lifelineslifelines that enable thethat enable the
injured to access medical careinjured to access medical care..
• protectingprotecting lifelineslifelines that enable thethat enable the
injured to access medical careinjured to access medical care..
• ensuring theensuring the structural integritystructural integrity
of the medical facilityof the medical facility
• ensuring theensuring the structural integritystructural integrity
of the medical facilityof the medical facility

30. MeasuresMeasuresMeasuresMeasures
• seismic integrityseismic integrity surveyssurveys
(structural and non-structural)(structural and non-structural)
• seismic integrityseismic integrity surveyssurveys
(structural and non-structural)(structural and non-structural)
• emergencyemergency planningplanning (...testing,(...testing,
revising, diffusing plans...)revising, diffusing plans...)
• emergencyemergency planningplanning (...testing,(...testing,
revising, diffusing plans...)revising, diffusing plans...)
• estimate medical, surgical,estimate medical, surgical,
pharmaceutical and logisticalpharmaceutical and logistical needsneeds
• estimate medical, surgical,estimate medical, surgical,
pharmaceutical and logisticalpharmaceutical and logistical needsneeds
• earthquakeearthquake casualtycasualty estimationestimation..• earthquakeearthquake casualtycasualty estimationestimation..

31. Health facility networkHealth facility network
emergency planemergency plan
OtherOther
hospitalshospitals
and clinicsand clinics
in the areain the area
ExternalExternal
emergency planemergency plan
Site of theSite of the
disasterdisaster
Internal emergency planInternal emergency plan
The three foci of medical emergency planningThe three foci of medical emergency planning

32. Disaster
in the medical
centre
Disaster
in the system
of medical
centres
Disaster
in the external
environment
Disaster
planning for
the medical
centre
Disaster
planning
for the system
of medical
centres
Disaster
planning for
the external
environment
Co-ordinated
EMS Disaster
plans

33. Disaster
T1
T1 T2
T2
T2
T2
Helicopter links
Telecommunications links
Ambulance routes Emergency bus transportation
Primary triage point Secondary triage points
Pulmonary
specialists
Burns
unit
Emergency
operations
commander Coroner Next-of-kin
Incident
command
post
Incident
commander
Hospital I
Hospital II
Mortuary
Secondary
treatment
centre
Emergency
operations
centre
Staging
area

34. NowNow
overover
toto
you!you!

35. 1.1. A major earthquake has severelyA major earthquake has severely
damaged a hospital which has a largedamaged a hospital which has a large
Accident & Emergency department and isAccident & Emergency department and is
located in the heart of a metropolitan area.located in the heart of a metropolitan area.
Describe how you would manage the situation.Describe how you would manage the situation.
2.2. A major earthquake has caused a row ofA major earthquake has caused a row of
tall apartment blocks to collapse. They weretall apartment blocks to collapse. They were
inhabited. Describe how you would manageinhabited. Describe how you would manage
the emergency response.the emergency response.
3.3. A major earthquake has left 15,000 peopleA major earthquake has left 15,000 people
unable or unwilling to return to their homes.unable or unwilling to return to their homes.
Describe how you would manage the shelterDescribe how you would manage the shelter
and structural survey problem.and structural survey problem.

36. Your resources:-Your resources:-
• PeoplePeople - personnel, experts, manpower- personnel, experts, manpower
• SuppliesSupplies - consumables, medicines, fuel- consumables, medicines, fuel
• EquipmentEquipment, vehicles, vehicles
• FacilitiesFacilities - buildings- buildings
• CommunicationsCommunications..