The Global Centre for Risk and Innovation (GCRI)
Hospitals, emergency dispatch, ambulances and fire and rescue services must work hardest when other infrastructure fails. They depend on power, water, medical gases, communications, fuel and staff who can reach work. This page sets out how these services lose function in a disaster, how facility safety and dependency are assessed, and what evidence serves the health and emergency authorities responsible for them.
Healthcare and emergency services · Lifeline system A · Register v5
| SS-12 | Electricity | Tier 1 | Flood 1-in-100 | 9 |
| WTW-2 | Water | Tier 1 | Flood 1-in-100 | 41 |
| DX-1 | Telecom | Tier 2 | Heat | 6 |
| H-Campus | Health | Tier 1 | Earthquake | 63 |
| PN-3 | Transport | Tier 2 | Storm surge | n/a |
red: SS-12 and its dependants
Fig.Asset criticality register. Design wireframe with placeholder names and illustrative values, not a record or a live system.
Hospital and emergency service continuity is the ability of hospitals, dispatch centres, ambulances and rescue services to keep working when other infrastructure fails. They depend on power, water, medical gases, communications, fuel and road access, and non-structural damage can stop care even when buildings stand.
For healthcare and emergency services, in GCRI's spatial-intelligence reading, the map opens on population density, flood water and true-colour imagery with relief in 3D and true colour from NASA GIBS, framed on Western Europe; 3 further NASA layers wait in the list.
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NASA GIBS / EOSDIS · ASTER GDEM (METI, NASA) · Blue Marble (NASA) · © OpenStreetMap contributors (ODbL) · Natural Earth
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For healthcare and emergency services, in GCRI's spatial-intelligence reading, the map opens on population density, flood water and true-colour imagery with relief in 3D and true colour from NASA GIBS, framed on Western Europe; 3 further NASA layers wait in the list.Satellite and model products as NASA publishes them, each with its own date; indicators, not assessments of any place; claim ceiling INTEGRATED.
Layers and dates
Essential facility dependencies. The dossier below sets out how the risk develops, what is measured, where the data come from, how it is modelled and who decides.
Operating theatres, intensive care and laboratories need continuous power, water and medical gases. Backup buys time, and fuel, water storage and supplier contracts determine how much.
Buildings may stand while equipment falls, ceilings collapse, pipes burst and lifts stop. Non-structural damage is a common reason for hospitals losing function after earthquakes.
Emergency calls, radio and computer-aided dispatch depend on telecommunications and power. Outages and call surges can block access to help.
Ambulances, staff and supplies need open roads. Floods, debris and traffic cut access to facilities even when the facilities themselves are intact.
Each term as this page uses it. Where a standard-setting body defines the term, the wording follows that body.
| Term | Definition |
|---|---|
| Safe hospital | A health facility that remains accessible and functioning at maximum capacity during and immediately after a disaster. |
| Hospital Safety Index | A WHO and PAHO tool that rates the structural, non-structural and functional safety of hospitals. |
| Computer-aided dispatch | Software that emergency services use to receive calls and assign and track response units. |
Each indicator carries its unit, its cadence, the kind of source behind it and the evidence label a value would carry. No values are shown: a programme supplies them under its own authority.
| Indicator | Unit | Cadence | Source type | Label |
|---|---|---|---|---|
| Hospital Safety Index rating | safety category | per assessment | Hospital Safety Index assessments | OFFICIAL |
| Hospitals with backup power for critical areas | percent of hospitals | annual | Facility assessments | REPORTED |
| On-site water storage | hours of normal use | per facility | Facility records | DECLARED |
| Emergency call answer time | seconds | monthly | Dispatch centre records | OBSERVED |
| Facilities reachable during flood scenarios | percent of facilities | per scenario | Access modelling | MODELLED |
| Health facility functionality after events | percent fully functional | per event | WHO HeRAMS and assessments | REPORTED |
The topic as a computational graph: named sources feed the methods, an evidence review gates the outputs, and the decisions stay with the authorities that hold them.
Fig. 02Nodes carry their type, two metric rows and a state; connectors show what feeds what; dashed frames name the owners; the timeline is the cadence. Design of the pipeline, not a record of a run.
Named public datasets and institutional records, each with its licence class. Sources by agreement are used only under their terms and never republished.
| Source | What it gives | Licence class |
|---|---|---|
| WHO and PAHO Hospital Safety Index guide | Assessment method for structural, non-structural and emergency management safety | Public, WHO terms of use |
| WHO Health Resources and Services Availability Monitoring System (HeRAMS) | Facility functionality and services in emergencies | By agreement; public summaries |
| Healthsites.io | Locations of health facilities from OpenStreetMap | Open, ODbL |
| National master facility lists | Official registers of health facilities | Licence per ministry |
| Emergency services performance statistics | Response and call handling times where published | Public records, licence per authority |
Critical Infrastructure prepares evidence. The decisions below are taken by the authorities named, under their own rules, and never by the platform.
| Who decides | The question | Evidence this page serves |
|---|---|---|
| Ministries of health | Which hospitals to strengthen, and in what order | Safety index results; dependency reviews |
| Hospital managers | Which backup systems and supplies to invest in | Endurance hours; non-structural safety evidence |
| Emergency services authorities | How to keep dispatch and response running in outages | Dispatch continuity reviews; access analyses |
A hospital is a dense cluster of dependencies. Life support, imaging, sterilization, refrigeration, laboratory testing and electronic records all need power. Dialysis, sterilization and sanitation need large volumes of water. Records, pharmacy systems and coordination need communications. Medicines, blood, oxygen and food arrive through logistics networks. When several lifelines fail at once, facilities can be forced to evacuate patients, which is itself dangerous.
Disasters both reduce capacity and increase demand. Injured people arrive while staff struggle to travel, and damage to buildings can make parts of a facility unusable. Emergency call centres and dispatch depend on telecommunications and power; their failure delays every response. Disaster experience across many countries has repeatedly shown that backup arrangements, rather than primary systems, determine whether facilities keep working.
Public health systems and their wider risks are studied at Health Nexus.
Structured assessments record each critical function's dependencies, reserves and tolerable outage duration.
Methods from structural and earthquake engineering assess whether buildings, equipment and utilities remain usable after earthquakes and storms.
Simulation from optimization and operations research and urban and transport engineering explores patient flows and staff access when networks are degraded.
Facility data is often confidential, backup systems are tested less than assumed, and demand surges are hard to predict. Clinical judgement remains outside the scope of engineering models.
The current service level is R0: information and enquiries. An enquiry receives a reference and names the next step; applications, payments, compute allocations and registrations open only when their team, terms and review capacity exist.