Field hospitals play a critically important role in disaster response, from natural calamities like flooding or hurricanes, to outbreak of disease and violent conflicts. These facilities are the primary drivers for reducing the human life consequences of disaster, and helping survivors recover more quickly. Ample equipment and staffing of field hospitals is key to their ability to provide the necessary speed, level of treatment and treatment capability to save as many lives as possible.
General Questions About Field Hospitals
How Are Field Hospitals Classified?
Field hospitals are always mobile, self-sufficient and self-contained facilities that are designed for the rapid implementation and (if necessary) expansion of health care. Generally, these facilities are used for emergency requirements during a specified period of time. Additionally, there are a few different variables that affect how a field hospital is classified. Field Hospital classification ranges from levels 1 to 4, which are assigned based on the following considerations:
- Battlefield Proximity
- Medical Staff Quota
- Supplies and Equipment (types and availability)
- Surgical Complexity
- Specialty Services (surgical or ancillary)
Field Hospitals are normally clearly marked, since the Geneva Convention dictates that conflicting parties are forbidden from attacking any people or buildings that display a Red Cross or Red Crescent emblem. Any such attack is considered a war crime.
How Are Field Hospitals Deployed?
When disaster strikes or military conflicts arise, the level of response and deployment of field hospitals is triggered based on the established nature of the event (or events), the caliber of the disaster’s impact, and also the notoriety of the event with donors and the public (media coverage has a significant impact on donations to relief agencies). Relief agencies, governments and other organizations usually work together to facilitate deployment of relief. The host country often conducts the initial analysis of need and sometimes additional analyses will be performed by other organizations if deemed necessary. Host countries can also delay the deployment of field hospitals and other foreign aid.
The host countries and aid organizations must assess the necessary speed of response with consideration to disasters that create immediate health needs requiring field hospitals. Other considerations include deciding whether the response should be driven by need or supply, prioritizing victim groups for response focus, planning a staged response or deploying a single large effort, and weighing the consequences of delays from additional needs assessments. All of these considerations will determine the specifics of how the field hospitals are equipped for the most effective disaster response.
Equipping Modern Field Hospitals
According to the World Health Organization, a field hospital responding to disaster needs to be operational within 24 hours of the event, have sufficient services to meet medical needs, and offer technology that can be operated by national health personnel. All field hospitals that will be used for disaster response will need to have some key additional attributes:
- Adequate Security
- Sufficient Resources
- Logistics Planning
Field Hospital Security
The protection of patients and hospital staff is top priority, and yet field hospitals in conflict areas are often lacking the staff and equipment to provide the elevated security that hospitals in these dangerous environments require. Hospitals must be highly stable and reliable facilities, equipped with key systems to ensure uninterrupted care such as power generators or standalone HVAC systems. Field hospital security programs must meet key security considerations, including layout, staffing, policy training, and availability of security personnel.
Despite the Geneva Convention’s mandate, sufficient field hospital security may require additional measures to protect against violent war crimes against their patients and staff. For example, the World Health Organization (WHO) conducted a 2012 study, in which there were reports of systematic targeting of doctors and patients in Syria. According to the reports, authorities had targeted doctors for treating injured combatants and demonstrators, while security agents went so far as to pull patients from public and private operating rooms in to torture or kill them. To address this concern, some hospitals in Syria were established underground, hidden under buildings like farmhouses, deserted facilities, and even Mosques and churches. In addition to serving wounded civilians and combatants, these field hospitals have often served members of the local population who are deprived of access to healthcare due to siege and military operations in the area.
Equipping modern field hospitals with the necessary security to protect patients and staff from this extreme, brutal and criminal violence may require additional manpower—military, private or a combination.
Sufficient Access to Necessary Resources
Speed is only one of the vital aspects of disaster response; solid preparedness plans and allocation of ample resources can make a response effort optimally effective or catastrophically deficient. Each field hospital should be deployed and maintained with the medical personnel, specialists, staff, equipment, medicine, and general facilities to support sufficient disaster response requirements.
The 2012 WHO study mentioned earlier in this guide found that in areas affected by the conflict in Syria, only about 50% of field hospitals were fully functioning. Although some were inadequate due to damage caused by destruction from combat, the primary reason so many field hospitals were functioning below standard was due to lack of sufficient equipment, staff, and medicine.
Disaster response initiatives should include budget planning and an effective supply chain in order to deliver these vital resources and ensure the fulfillment of ongoing needs. Funding from governments and relief organization donations often causes budget constraints that can cripple a humanitarian supply chain, so financial support planning is a critical part of the resource planning process.
Effective, Economical Logistics Planning
Disaster response carries an understandably large and yet unquestionably necessary expense. Human lives are at stake, so logistics efficiency and timeliness is deeply vital. Logistics is the overarching term to include delivery, transportation and distribution of relief, from the field hospital systems themselves, to ongoing supply of necessary resources. Humanitarian disaster response efforts commonly struggle with uncertainties such as the location and magnitude of the disaster, as well as the specific needs of its victims and survivors.
Preparedness, flexibility and in-depth planning is essential for the most effective response.
However, those aspects of disaster response can require quite the cost. Several studies have estimated that around 80 percent of disaster response funds are spent on logistics, making this area one of the most expensive aspects of disaster response. Logistics efficiency or lack thereof makes a dramatic difference in not only the cost of responding to a disaster event, but also in the aid organization’s ability to provide augmented or additional help.
When planning logistics for a relief effort, the field hospital should be capable of supplying two features that are important for efficient disaster response:
- Portability: It’s often very difficult to predict the comprehensive need for victims of a disaster, so response facilities must be adaptable to provide the most effectual support. A portable field hospital is ideal, since it can be easily relocated to areas of the greatest need, thus reducing lead times and ensuring more timely care for victims.
- Versatility: Disasters almost never result in a single event or issue; there are usually consequential events that require emergency response or resources, and field hospitals need to be versatile in order to address them sufficiently. With buildings that can be easily moved or adjusted, rapid access to additional or new resources (such as medicine, special machines, or personnel), and systems that can be flexible to their environment, versatile field hospitals can be most effective.
After a disaster, responding to the needs of victims and survivors takes priority, yet communities can reduce the effects of future disaster by implementing disaster preparedness plans. We continue to see increased natural disasters due to climate change, so the risk of catastrophic natural events is augmented as well. Disaster planning is important for local communities, as well as families and individuals. Increasing awareness throughout your community, and sharing resources such as a comprehensive disaster planning guide can make a significant difference toward reducing the harm if disaster does strike.