This article originally appeared on the Humanitarian Coalition’s Relief to Recovery blog, here.
Just a few days since the 7.8-magnitude earthquake hit Nepal, three inflatable tents—each measuring over 1,000m2 in floor space—arrive at the airport in Katmandu. Folded and deflated upon arrival, each tent weighs 2,600 lbs and requires 10 people to carry it from the plane to a waiting truck, which begins a slow and difficult journey to the relief site in the mountainous Gorkha district. Upon its arrival, staff work frantically in shifts throughout the following days and nights to set up a fully-functioning inflatable hospital.
These hospitals are seamlessly designed for natural disaster response. They arrive with pumps attached for effective assembly. The waterproof walls are made of nylon, which is easily scrubbed to maintain sanitary conditions. The windows and mesh screening allow for ventilation. The plastic tile floor is made of same material used for inflatable lifeboats. The roof rests on inflatable tubes.
These tents had their unlikely beginnings in a warehouse in Bordeaux, where Médicins Sans Frontières (MSF) stores the life-saving facilities. No packing was required when the first quake hit—the necessary medical and surgical equipment was prepared in kits, containing everything from gauze and fluid bags to antibiotics and sutures. Tents are equipped with every essential necessary to run a hospital, including beds, surgical lamps, medical and biomedical equipment and air conditioning, all deployed at a moment’s notice. You’ll find sinks, waste disposal units, nursing stations and operating tables. Partitions divide the hospital into sections, with operating suites separated from post-operative units. Decontamination areas and distinct spaces for clean equipment keep the tents sterile. The hospital comes equipped with independent water and power systems – necessities that are often unavailable under emergency conditions. Staff have the option between using a 30- or 60-kilovolt generator. Electrical equipment is set up to provide wiring and outlets, and to ensure electrical safety. No detail has been overlooked.
Overcoming challenges to meet needs quickly
Logistics and transportation are daunting challenges in the aftermath of a natural disaster. Hospitals also require 5,000m2 of flat and clear terrain (difficult in the Himalayas). But during emergency response, time is of the essence, and regular health facilities could take months to be rebuilt. Inflatable hospitals quickly and effectively relieve pressure from local communities. Their portability and flexibility allows them to meet conditions of the region the serve. Pre-packed and ready to deploy, they get the doors open fast—tents can be erected in 48 hours. They provide a sterile, safe space for patient care. These facilities offer immediate emergency care and surgery, and provide secondary healthcare while local centers are rebuilt. Additionally, they provide comfort amidst distress. Patients haunted by memories of collapsing buildings reportedly feel safer in the tents, and healthcare providers notice decreased patient anxiety, improved sleeping patterns, and even a decrease in requests for sedatives.
Impressive as these structures are, mobile and inflatable hospitals have a long history. In the 1940s, the US army set up Mobile Army Surgical Hospitals (MASH) near the frontlines. The French Army realized the benefits of inflation in 1959, and parachuted tent hospitals to battlefields in North Africa. Fast forward a few decades and NGOs like MSF have perfected these affectionately titled “plug-and-play” hospitals, among other emergency relief innovations like IKEA’s flat-pack solar powered refugee shelters and fast form emergency shelters.
These tents were first used by MSF in response to the 2005 earthquake in Kashmiri, Pakistan. They were deployed in Haiti after the 2010 earthquake and in the Philippines after Typhoon Haiyan. In the decade since Pakistan’s earthquake, indisputable improvements have been made to the hospitals. Response teams have learned from mistakes and experiences in various settings, and technology and deployment strategies have been adjusted accordingly. One case study describes how tents deflated nightly in Pakistan due to a drop in temperature and air pressure. In Nepal, each tent is equipped with gauges that automatically trigger re-inflation when pressure levels get low. MSF’s experience implementing these hospitals in different environments has led to the tremendous impact they have had in Nepal.
By May 8, a 20-bed inflatable hospital was operating in Arughat, Gorkha district, the rural epicenter of the first earthquake. This hospital provided critical relief in the following months while the Ministry of Health reconstructed a semi-permanent facility nearby. Patients walked for up to five days to reach the tents, revealing how badly the healthcare system was damaged by the earthquakes. Throughout this time, 15 patients were treated daily in the emergency room. An additional 100 patients were treated in the outpatient department every day, which provided basic healthcare and response to common ailments, chronic conditions, disease outbreaks, follow-up surgeries and infections, and delivered psychosocial support. The hospital even provided maternity care, and the first baby was born just four days after doors opened.
This inflatable hospital treated over 10,000 patients in the region. The impact and success of this facility is a true tribute to what MSF and other organizations have learned over the years, and allowed for the provision crucial support to the Nepalese healthcare system as the nation rebuilds.