2nd INTERNATIONAL CONFERENCE ON

EARTHQUAKE ENGINEERING AND POST

DISASTER RECONSTRUCTION PLANNING
(ICEE-PDRP 2019)
25-27 APRIL 2019, BHAKTAPUR, NEPAL

Hospital Retrofitting in Nepal: a case study of Bhaktapur Hospital

Santosh Shrestha, PhD1, Sunil Khadka2 and Gyanedra Shakya3

The recent 2015 Gorkha earthquakes severely affected the health sector. According to MoHA,
2017, total of 446 public health facilities and 16 private facilities were completely destroyed and a
total of 765 health facilities or administrative structures were partially damaged. The total monetary
value of damages and losses due to the earthquakes in health sector is estimated to be NPR 7.5 billion.
According to the Health Infrastructure Information System data, 191 facilities in the 14 most affected
districts were extensively damaged or destroyed to the extent that they required replacing, while
further 291 facilities required rehabilitation or retrofitting. In the rural area, significant number of
unreinforced masonry buildings constructed of stone or brick in mud mortar exist throughout the
country. These buildings are highly vulnerable to even moderate earthquake and require immediate
attention based on the hazard and risk assessment conducted by Ministry of Health & Population
(MoHP) and DFID’s studies. Most of the existing big hospitals in cities are also vulnerable to seismic
risks and recommended for seismic retrofitting as well as rebuild (Turner & Townsend, 2015).
A detailed damage assessment of health infrastructures conducted by Nepal Health Sector Support
Programme (NHSSP) in 2016 -2017 shows that most of hospital and health facility buildings have
serious functional problems which is affecting hospital services. For high priority structures like
hospital buildings, the vulnerability of functional features including non-structural components of the
buildings can lead to severe non-structural and functional damages and indirect losses after the events
which may far exceed the loss caused by the structural damages. In addition, the recent report of Joint
Assessment Review (MoH,2018) highlights that major hospitals and health facilities of both rural and
urban area have issues in planning, designing and maintenance along with indoor air quality, water
supply, waste management and energy system. More than 500 health facilities have lack of basic
services especially water supply and electricity in Nepal. In this context, the recent studies highlight
that there is a needs of retrofitting and rehabilitation of health infrastructures not only to increase
seismic safety but also to upgrade functional requirements as per current standards. Besides it is also
very important to improve water, energy and environmental performance of hospital as well as
improve the comfort and indoor air quality of the hospital buildings.
To address the above mentioned needs of retrofitting and rehabilitation of hospital buildings,
NHSSP Infrastructure Team has introduced an approach including three folds of retrofitting – seismic
(structural and non-structural), functional and green retrofitting - for retrofiting and rehabilitation of
two major hospitals under UKAid/DFID funding. This paper presents findings and proposed
approaches of seismic, functional and green retrofitting of hospital buildings in Nepal based on a case
study of Western Regional Hospital and Bhaktapur Hospital.

1
Senior Earthquake Resilience Advisor, Nepal Health Sector Support Programme –III, Ministry of Health and
Population, Ramshahpath, Kathmandu, Nepal, E-mail:santosh@nhssp.org.np
2
Lead Advisor - Infrastructure, Nepal Health Sector Support Programme –III, Ministry of Health and Population,
Ramshahpath, Kathmandu, Nepal, E-mail:sunil@nhssp.org.np
3
Senior Architect, Nepal Health Sector Support Programme –III, Ministry of Health and Population,
Ramshahpath, Kathmandu, Nepal, E-mail:gyanedra@nhssp.org.np

1
 An MSF team assessed the situation in Bhaktapur (east of
Kathmandu), which has experienced destruction. The hospital there
does not have a functional operating theatre and all cases are being
referred to Kathmandu. People are staying in makeshift shelters in the
open air, and the sanitation conditions are concerning, with no latrines
and only scarce water
(https://www.doctorswithoutborders.ca/article/victims-twice-over-msf-
continues-assist-people-affected-two-earthquakes-nepal)

Reference

MoHA, 2017: Lesson learn from Gorkha Earthquake, MoHA, Government of Nepal

MoH, 2018, Report of Joint Assessment Review, Ministry of Health, Government of Nepal

Turner & Townsend, RAMBOLL, 2015 Report for DFID Nepal Hospital Seismic Retrofitting
Programme – Earthquake Damage Assessment of Hospitals,