The 22nd February 2011, Mw 6.3 Christchurch earthquake in New Zealand caused major damage to critical infrastructure, including the healthcare system. The Natural Hazard Platform of NZ funded a short-term project called “Hospital Functions and Services” to support the Canterbury District Health Board’s (CDHB) efforts in capturing standardized data that describe the effects of the earthquake on the Canterbury region’s main hospital system. The project utilised a survey tool originally developed by researchers at Johns Hopkins University (JHU) to assess the loss of function of hospitals in the Maule and Bío-Bío regions following the 27th February 2010, Mw 8.8 Maule earthquake in Chile. This paper describes the application of the JHU tool for surveying the impact of Christchurch earthquake on the CDHB Hospital System, including the system’s residual capacity to deliver emergency response and health care. A short summary of the impact of the Christchurch earthquake on other CDHB public and private hospitals is also provided. This study demonstrates that, as was observed in other earthquakes around the world, the effects of damage to non-structural building components, equipment, utility lifelines, and transportation were far more disruptive than the minor structural damage observed in buildings (FEMA 2007). Earthquake related complications with re-supply and other organizational aspects also impacted the emergency response and the healthcare facilities’ residual capacity to deliver services in the short and long terms.
The magnitude 6.2 Christchurch earthquake struck the city of Christchurch at 12:51pm on February 22, 2011. The earthquake caused 186 fatalities, a large number of injuries, and resulted in widespread damage to the built environment, including significant disruption to lifeline networks and health care facilities. Critical facilities, such as public and private hospitals, government, non-government and private emergency services, physicians’ offices, clinics and others were severely impacted by this seismic event. Despite these challenges many systems were able to adapt and cope. This thesis presents the physical and functional impact of the Christchurch earthquake on the regional public healthcare system by analysing how it adapted to respond to the emergency and continued to provide health services. Firstly, it assesses the seismic performance of the facilities, mechanical and medical equipment, building contents, internal services and back-up resources. Secondly, it investigates the reduction of functionality for clinical and non-clinical services, induced by the structural and non-structural damage. Thirdly it assesses the impact on single facilities and the redundancy of the health system as a whole following damage to the road, power, water, and wastewater networks. Finally, it assesses the healthcare network's ability to operate under reduced and surged conditions. The effectiveness of a variety of seismic vulnerability preparedness and reduction methods are critically reviewed by comparing the observed performances with the predicted outcomes of the seismic vulnerability and disaster preparedness models. Original methodology is proposed in the thesis which was generated by adapting and building on existing methods. The methodology can be used to predict the geographical distribution of functional loss, the residual capacity and the patient transfer travel time for hospital networks following earthquakes. The methodology is used to define the factors which contributed to the overall resilence of the Canterbury hospital network and the areas which decreased the resilence. The results show that the factors which contributed to the resilence, as well as the factors which caused damage and functionality loss were difficult to foresee and plan for. The non-structural damage to utilities and suspended ceilings was far more disruptive to the provision of healthcare than the minor structural damage to buildings. The physical damage to the healthcare network reduced the capacity, which has further strained a health care system already under pressure. Providing the already high rate of occupancy prior to the Christchurch earthquake the Canterbury healthcare network has still provided adequate healthcare to the community.
The Sendai Framework for Disaster Risk Reduction 2015-2030 finds that, despite progress in disaster risk reduction over the last decade “evidence indicates that exposure of persons and assets in all countries has increased faster than vulnerability has decreased, thus generating new risk and a steady rise in disaster losses” (p.4, UNISDR 2015). Fostering cooperation among relevant stakeholders and policy makers to “facilitate a science-policy interface for effective decisionmaking in disaster risk management” is required to achieve two priority areas for action, understanding disaster risk and enhancing disaster preparedness (p. 13, p. 23, UNISDR 2015). In other topic areas, the term science-policy interface is used interchangeably with the term boundary organisation. Both terms are usually used refer to systematic collaborative arrangements used to manage the intersection, or boundary, between science and policy domains, with the aim of facilitating the joint construction of knowledge to inform decision-making. Informed by complexity theory, and a constructivist focus on the functions and processes that minimize inevitable tensions between domains, this conceptual framework has become well established in fields where large complex issues have significant economic and political consequences, including environmental management, biodiversity, sustainable development, climate change and public health. To date, however, there has been little application of this framework in the disaster risk reduction field. In this doctoral project the boundary management framework informs an analysis of the research response to the 2010-2011 Canterbury Earthquake Sequence, focusing on the coordination role of New Zealand’s national Natural Hazards Research Platform. The project has two aims. It uses this framework to tell the nuanced story of the way this research coordination role evolved in response to both the complexity of the unfolding post-disaster environment, and to national policy and research developments. Lessons are drawn from this analysis for those planning and implementing arrangements across the science-policy boundary to manage research support for disaster risk reduction decision-making, particularly after disasters. The second aim is to use this case study to test the utility of the boundary management framework in the disaster risk reduction context. This requires that terminology and concepts are explained and translated in terms that make this analysis as accessible as possible across the disciplines, domains and sectors involved in disaster risk reduction. Key findings are that the focus on balance, both within organisations, and between organisations and domains, and the emphasis on systemic effects, patterns and trends, offer an effective and productive alternative to the more traditional focus on individual or organisational performance. Lessons are drawn concerning the application of this framework when planning and implementing boundary organisations in the hazard and disaster risk management context.
