Seismic Structural Design in Developing Countries: The Impact on the Design of Healthcare Facilities

Seismic Structural Design in Developing Countries: The Impact on the Design of Healthcare Facilities By Angeline Stimpson

Arch 595 - Independent Study Professor Marci Uihlein University of Illinois - Urbana/Champaign

Table of Contents:

Abstract

i

Chapter 1: What is Seismic Design?

Chapter 2: Health and Healthcare of Developing Countries Chapter 3: Seismic Risk in Developing Countries

1-5 6 - 13 14 - 15

Chapter 4: Non-Engineered Dwelling Structures in Developing

Countries

16 - 20

Chapter 5: Non-Engineered Structures and its Application to

Developing Countries

Chapter 6: Seismic Design and Healthcare Conclusions Acronyms

21 - 25 26 - 30 31

List of Figures

32 - 33

References

34 - 36

Appendix I: Interview with David Bibbs Appendix II: Interview with Professor Mir Ali

a-1 - a-8 a-9 - a-12

ABSTRACT

In the United States, building codes were originally developed by ad hoc committees and volunteers. After the 1971 San Fernando earthquake, the federal government decided to aid in the process of creating a more accurate, nationwide seismic code. In the past few years, the constant updating of seismic code and advances in technology has forced the building industry to increase its awareness of how earthquakes affect structures in order to prevent damage caused by seismic forces.

According to the CIA World Factbook, the majority of the world’s countries are classified as developing countries. These countries face many other issues such as high infant mortality rates, hunger, disease, and poverty that tend to place seismic design as a lower priority. Therefore, very few developing nations have seismic regulations and technologies to help build earthquake resistant structure. Unfortunately, many developing countries are in some of the highest seismic zones in the world yet they have little or no knowledge of how to design such hazards. In addition, the healthcare systems in many developing countries are greatly lacking in supplies, knowledge, technology and personnel. However, if these hospitals cannot survive an earthquake and aid in the recovery of the aftermath, they may become obsolete. In this report, I wish to address the difficulties in applying seismic design to developing countries with special emphasis on healthcare facilities.

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Chapter 1: What is Seismic Design?

Figure 1-1: Seismicity Map of South America

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**Figure courtesy of the U.S. Geological Survey

The main cause of earthquakes is movement within the earth’s crust. The earth’s crust is a thin shell of rock that is divided up into large plates called tectonic plates. The names of major plates that currently exist are as follows: North American, Eurasian, Pacific, Indo-Australian, Antarctic, African and South American. Gravity, the earth’s rotational forces, and convection of the earth’s molten core cause these plates to be constantly under pressure. As this pressure builds, the plates can shift causing the intense ground shaking that is more commonly referred to as an earthquake.

The two most common scales that measure an earthquake are the Richter scale and the Modified Mercalli scale. The Richter scale, invented by C.F. Richter, measures the magnitude or the scale of an earthquake based on a “standard seismic wave measuring instrument deflected, when located a standard distance from the place where an earthquake occurred”.1 The earthquake is measured on a scale ranging from zero to nine. Zero means that little to no energy from the earthquake was released from the earth’s crust. Therefore, a measure of nine only occurs when the magnitude of the earthquake is very strong. Between each unit on the Richter scale there is a magnification of thirty two times the energy released. For example, one earthquake is measured as a 5 on the Richter scale and the second earthquake is measured as a 6. The second earthquake is thirty two times larger than the first earthquake. There are problems that exist with the Richter scale and it is not commonly used by scientists.

The Richter scale depends on an instrument being a standard distance away from an earthquake when it occurs and the likely hood of this happening is pretty slim. Since the Richter scale is not entirely accurate, scientists looked into measuring the earthquakes Figure 1-2: World’s Tectonic Plates

**Figure courtesy of http://science-at-home.org/earthquakes-and-tectonic-plates/ 1 American Institute of Steel Construction. “Facts for Steel Buildings #3.” AISC | Home. Web. 19 Apr. 2011.

<http://www.aisc.org/WorkArea/showcontent.aspx?id=22784>.

2.

Table 1-1: Modified Mercalli Scale

**Figure courtesy of the United States Geological Survey

intensity instead of its magnitude. The Modified Mercalli scale is a prime example of a system that measures the intensity or severity of an earthquake. This scale uses Roman Numerals from I to XII that correspond with the amount of ground shaking felt and resulting damage. According to the United States Geological Survey (USGS), a level I is “not felt except by a very few under especially favorable conditions” and a level XII is “damage total; lines of sight and level are distorted; objects thrown into the air”.2 The above table provides the USGS’s explanation of the Modified Mercalli scale.

This scale tends to be easier to understand for the general population however, it is not specific enough for engineering purposes. The Modified Mercalli scale is helpful after an earthquake occurs. Also it is hard to “use intensity directly in structural analysis”.3 Since measuring earthquakes and correlating that measurement into an engineer’s calculations is difficult the ability to structurally design a building for seismic forces becomes increasingly more troublesome.

2 U.S. Geological Survey. “Plates of the Earth.” U.S. Geological Survey Earthquake Hazards Program. Web. 19 Apr. 2011.

<http://earthquake.usgs.gov/learn/topics/plate_tectonics/plates.php>.

3 U.S. Geological Survey. “Plates of the Earth.” U.S. Geological Survey Earthquake Hazards Program. Web. 19 Apr. 2011.

<http://earthquake.usgs.gov/learn/topics/plate_tectonics/plates.php>.

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The one of the main reason earthquakes can impact buildings so drastically is due to permanent ground damage. When an earthquake occurs, the ground can shift, slide, liquefy, rip and vibrate. All of these motions are translated to a buildings foundation and subsequently to the above ground structure, also known as the superstructure. The design goal of the entire structure is to limit the damage caused by the ground motions and to protect the buildings occupants. Certain foundations are used due to their ability to resists distinct ground movements. Generally speaking, specific areas are prone to specific permanent ground deformations depending on the soil type, relative location to a fault line, and relative location to various geological features like hills, mountains, water and volcanoes. Pile foundations, for instance, can perform fairly well in soil conditions where liquefaction is a potential threat. “Liquefaction is a phenomenon wherein a mass of soil looses a large percentage of its shear resistance, when subjected to a monotonic, cyclic or shock loading, and flows in a manner resembling a liquid until the shear stresses acting on the mass are as low as the reduced shear resistance”.4 In other words, this is when the soil starts to act more like water and tends to flow rather than stay solid like rock due to the high energy concentrations caused by earthquakes.

Foundations depend on the bearing capacity of soil. Bearing capacity can be defined as the allowable pressure between the soil and the foundation. When the bearing capacity of the soil is disturbed, like in liquefaction, or overloaded, the structure can no longer transmit loads from the superstructure to the ground.

The biggest threat though is the grounds ability to shake and cause the structure to sway. When the ground shakes, the foundations will shake at approximately the same frequency. The superstructure, on the other hand, will move at a different rate due to inertia and its more flexible nature. This process of the two elements of the structure moving somewhat independently from each other is repeated throughout the duration of the earthquake. Since the two parts of the structures are moving at different paces, great damage can result if these two frequencies become dramatically different.

Every structure has a natural frequency depending on the structure’s mass and stiffness distributions. Earthquake frequencies can excite a buildings natural frequency causing it to deform in a multitude of ways. The greater the difference in frequencies between the ground and the structure, the greater the seismic force applied to the structure and therefore the greater amount of damage occurs. The greater the difference in frequencies, the greater the seismic force applied to the structure and therefore the greater amount of damage occurs. The goal is to design a structure that can withstand these multiple frequencies so that the function of the building is not hindered by the earthquake to use immediately during and after the hazard. This is a challenge because each building reacts differently to an earthquake and different seismic forces are applied to different buildings during an earthquake. Essentially, there is no one solution to solve every building to withstand seismic energy.

According to the American Institute of Steel Construction (AISC), there are a few important aspects of a building’s design to incorporate when the building is to adequately perform under seismic conditions. These aspects include ductility, continuity, stiffness and strength, regularity, and redundancy.5 Ductility is the structures ability to carry a load that is beyond its elastic limit. In the case of a seismic event, this means that the structure can move under the seismic loads without falling. A structure with no 4 J. A. Sladen, R. D. D’Hollander and J. Krahn. “The Liquefaction of Sands, A Collapse Surface Approach.” EBA Engineering

Consultants Ltd. July 22, 1985.

5 American Institute of Steel Construction. “Facts for Steel Buildings #3.” AISC | Home. Web. 19 Apr. 2011.

<http://www.aisc.org/WorkArea/showcontent.aspx?id=22784>.

4.

ductility would instantly fail in an earthquake because it is incapable of moving. A nonductile structure performs more like a brittle material in which it is easily broken with little force. Continuity is another important aspect to seismically designed buildings.

The entire structure must act as one unit when under earthquake forces. Therefore, all the elements of the structure must be connected together to adequately support one another and work together to transfer earthquake loads as needed. If the loads have a continuous path of travel, they can easily be transferred to the ground without any disruptions. This is where stiffness and strength become a factor. The building needs to be stiff enough so that the deformations caused by the lateral swaying of the structure during an earthquake do not result in a collapse. The stiffness is due to building and member geometry but a structureâ&#x20AC;&#x2122;s strength is related to the allowable performance of the members.

If all the members of a structure are to act as a whole, regularity and redundancy can aid in this process. Regularity refers to the buildings configuration and how it will react to lateral forces. It is desirable for the structure to laterally deform evenly throughout the height of the building, to avoid stress concentration areas and to have very little torsion on the structures. A building that is shaped asymmetrically with multiple protrusions will have uneven deformation and localized high concentrations of stress and torsion which can severely damage, and crack the structure. This can cause the structure to collapse. If a structure is designed to have multiple members capable of taking the lateral deformations and forces, it will be more likely to stay erect if one or more members fail during an earthquake. This is considered a buildings redundancy.

The more members there are to carry lateral loads, the higher a buildingâ&#x20AC;&#x2122;s redundancy and the more likely it is to survive a hazard if a member is stressed beyond its bearing capacity. These six factors demonstrate how to greatly improve a structureâ&#x20AC;&#x2122;s ability to take seismic loading.

As explained above, seismic design is no easy task. It is complicated to implement, has multiple solutions, and varies for every different type of building, material and site location. The goal of this paper is to address the issues of achieving such an intricate process into countries where the literacy rate is may be extremely low and the local people may be suffering from disease, hunger, and poverty.

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Chapter 2: Health and Healthcare in Developing Countries

Figure 2-1: Interior View of a Hospital

**Image courtesy of GeoHazards International

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Figure 2-2: Comparison of Developed and Developing Countries

**Information for this figure courtesy of the CIA Factbook

According to the Central Intelligence Agency (CIA) World Factbook, the majority of the world’s countries are considered developing countries.1 The CIA has three categories to classify a country’s status. From top to bottom, the CIA classifies countries into the following categories: developed, less developed, and developing. These classifications are based off of the International Monetary Fund (IMF) who categorizes countries depending on their gross national product (GNP). The United Nations (UN) and the World Bank use similar classification systems but have slightly differing results. For example, the following countries are considered developed by the UN but not the IMF: Barbados, Brunei Darussalam, Estonia, Hungary, Poland, Qatar, and United Arab Emirates.2

The CIA Factbook defined the following 126 countries as “developing countries”: Afghanistan, Algeria, Angola, Antigua and Barbuda, Argentina, Aruba, The Bahamas, Bahrain, Bangladesh, Barbados, Belize, Benin, Bhutan, Bolivia, Botswana, Brazil, Burkina Faso, Burma, Burundi, Cambodia, Cameroon, Cape Verde, Central African Republic, Chad, Chile, China, Colombia, Comoros, Democratic Republic of the Congo, Republic of the Congo, Costa Rica, Cote d’Ivoire, Cyprus, Djibouti, Dominica, Dominican Republic, Ecuador, Egypt, El Salvador, Equatorial Guinea, Ethiopia, Fiji, Gabon, The Gambia, Ghana, Grenada, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Honduras, India, Indonesia, Iran, Iraq, Jamaica, Jordan, Kenya, Kiribati, Kuwait, Laos, Lebanon, Lesotho, Liberia, Libya, Madagascar, Malawi, Malaysia, Maldives, Mali, Malta, Marshall Islands, Mauritania, Mauritius, Mexico, Federated States of Micronesia, Morocco, Mozambique, Namibia, Nepal, Netherlands Antilles, Nicaragua, Niger, Nigeria, Oman, Pakistan, Panama, Papua New Guinea, Paraguay, Peru, Philippines, Qatar, Rwanda, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, Sao Tome and Principe, Saudi Arabia, Senegal, Seychelles, Sierra Leone, Solomon Islands, Somalia, South Africa, Sri Lanka, Sudan, Suriname, Swaziland, Syria, Tanzania, Thailand, Togo, Trinidad 1 Central Intelligence Agency. “CIA - The World Factbook.” Welcome to the Central Intelligence Agency. Web. 07 Apr. 2011.

<https://www.cia.gov/library/publications/the-world-factbook/index.html>.

2 Nielsen, Lynge. “Classifications of Countries Based on Their Level of Development: How It Is Done and How It Could Be Done.”

International Monetary Fund Publications - Working Papers. International Monetary Fund. Web. 9 May 2011.

<http://www.imf.org/external/pubs/ft/wp/2011/wp1131.pdf>.

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and Tobago, Tunisia, Turkey, UAE, Uganda, Uruguay, Vanuatu, Venezuela, Vietnam, Yemen, Zambia, and Zimbabwe.

As an extension of “developing countries”, the following 46 countries should be included even though they are categorized under the heading “less developed countries”: American Samoa, Anguilla, British Virgin Islands, Brunei, Cayman Islands, Christmas Island, Cocos Islands, Cook Islands, Cuba, Eritrea, Falkland Islands, French Guiana, French Polynesia, Gaza Strip, Gibraltar, Greenland, Grenada, Guadeloupe, Guam, Guernsey, Isle of Man, Jersey, North Korea, Macau, Martinique, Mayotte, Montserrat, Nauru, New Caledonia, Niue, Norfolk Island, Northern Mariana Islands, Palau, Pitcairn Islands, Puerto Rico, Reunion, Saint Helena, Ascension, and Tristan da Cunha, Saint Pierre and Miquelon, Tokelau, Tonga, Turks and Caicos Islands, Tuvalu, Virgin Islands, Wallis and Futuna, West Bank, and Western Sahara. This means that about 89% of the world is considered a non-developed economy (See Figure 2-3).

Figure 2-3: Developing vs. Developed World Map

**Information for this figure courtesy of the CIA Factbook

In order to combat this large percentage, the United Nations (UN) has created eight goals to encourage collaborative action to help solve some of the world’s largest issues such as poverty, hunger, education, gender equality, child health, maternal health, HIV/AIDS, environmental sustainability and global partnership. These goals are referred to as the Millennium Development Goals (MDGs).3 Millennium Development Goals: 1.

To eradicate extreme poverty and hunger 2.

To achieve universal primary education 3.

To promote gender equality and empower women 4.

To reduce child mortality 5.

To improve maternal health 6.

To combat HIV/AIDS, malaria, and other diseases 7.

To ensure environmental sustainability 8.

To develop a global partnership for development 3 United Nations. “United Nations Millennium Development Goals.” A Gateway to the UN System’s Work on the MDGs. Web. 03

Feb. 2011. <http://www.un.org/millenniumgoals/>.

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Each of these goals was derived from the United Nations Millennium Declaration in which each world leader signed with the intent that these goals will be reached by 2015.

Seven of the eight goals are directly related to health and therefore the World Health Organization (WHO) has become directly involved with the achievement of the MDGs. In addition to defining the MDGs, the UN has also set specific targets to reach by 2015 Table 2-1: Millennium Development Goals

**Information for this figure courtesy of the United Nations

(See Table 2-1). These targets enable countries to quantify their progress in achieving the MDGs. The United Nations is teaming up with the following organizations in order to accomplish the MDGs. • United Nations Development Programme – UNDP • Millennium Campaign • UN Department of Economic & Social Affairs – UNDESA • World Bank • UN Children’s Fund – UNICEF • UN Environment Programme – UNEP • UN Population Fund – UNFPA • World Health Organization – WHO • International Monetary Fund – IMF • UN Human Settlements Programme - UN-HABITAT • Food & Agriculture Organization – FAO

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• International Fund for Agricultural Development – IFAD • International Labour Organization – ILO • International Telecommunications Union – ITU • Joint UN Programme on HIV/AIDS – UNAIDS • UN Development Group – UNDG • UN Educational, Scientific and Cultural Organization – UNESCO • UN Refugee Agency – ANHCR • UN Industrial Development Organization – UNIDO • UN Development Fund for Women – UNIFEM • Office of the High Commissioner for Human Rights – OHCHR • UN Relief and Works Agency for Palestine Refugees in the Near East – UNRWA • World Food Programme – WFP • World Meteorological Organization – WTO • World Tourism Organization – UNWTO • UN Office on Sport for Development and Peace – UNOSDP • UN Conference on Trade and Development – UNCTAD

The global concern for world health has become an increasingly important aspect because the majority of the world’s largest issues could be improved if the health of developing countries is improved. Poorer countries face problems like hunger, high infant and maternal mortality rates, low literacy rates, and shorter life spans for example (See Figure 2-4). Many of these people depend on their health so that they may work to support their families. Without being able to work and having so few resources to support themselves, many people could lose everything they own.

Figure 2-4: Maternal Mortality Ratio, by Country, of 2005

**Map courtesy of the World Health Organization at http:// www.who.int/making_pregnancy_safer/topics/maternal_ mortality/en/index.html

One of the biggest factors in the state of health in developing countries is women’s health. Women have very limited resources to health education outside the home such as in their childhood education or any resources developed by healthcare professional.

In Afghanistan, only about thirty percent of girls have access to education.4 Some of the factors that influence a girls’ ability to attend school include but are not limited to 4 United Nations Girls’ Education Initiative. “Afghanistan: Background.” UNGEI. Web. 31 Jan. 2011.

http://www.ungei.org/infobycountry/afghanistan.html.

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Figure 2-5: Main Factors for Afghan Girls to

Not Attend School

child marriage, security of the school, accessibility to the school, poverty, and work (See Figure 2-5). This is not just the case in Afghanistan but a dilemma that many developing countries face. If young girls are unable to attend school, then the likelihood of a women learning to read or write during her lifetime becomes increasingly low. Thus making it that much more difficult to instill good health care practices, teach women about **Information for figure courtesy of the experiences they will go through the UN Girls’ Education Initiative with their bodies and inform expectant mothers on how to care for their baby.

Part of the concern in women’s health is gender equality in addition to access to education. In some countries, women are seen as the lesser of the sexes. In many cases, women may have very limited rights such as not having the right to vote, go to school, wear what they want, marry who they please and etc. Child marriages are still fairly common in developing nations. A female child can be used to settle a debt by marrying her off to the lender, and to gain social status by obtaining multiple wives.

Gender inequality has also led to multiple cases of physical and mental abuse. In August 2010, the New York Times published an article entitled “What Happens When We Leave Afghanistan” with the cover of the magazine featuring young Bibi Aisha.5 Aisha, at the age of twelve, and her sister, age ten, were given to a Taliban soldier’s family to settle a blood debt between the two families. When she reached puberty, she was wed to the Taliban soldier. While her husband was away fighting, she was kept at her in-laws home and was used as a slave and frequently beaten by her uncle. After escaping the abuse, she was found by her husband and as a form of discipline, he cut off her ears and nose. She was found disfigured and in shock and taken to a shelter in Kabul. The shelter was able to find Grossman Burn Foundation to Figure 2-6: Total Fertility Rate of Country

**Information for figure courtesy of the CIA Factbook 5 Nordland, Rod. “Time Magazine Cover of Disfigured Afghan Stokes Debate - NYTimes.com.” The New York Times. 04 Aug. 2010.

Web. 30 Apr. 2011. <http://www.nytimes.com/2010/08/05/world/asia/05afghan.html?scp=1>.

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provide free reconstructive surgery for Aisha. Since Aisha and her story, many more reports about abuse in developing countries have surfaced.

Developing countries tend to have very few educational institutions available to its native population. If financially possible, some people from developing countries will escape to another country in order to receive a better education. As a result, there are very few physicians that exist in developing countries. This makes it increasingly harder to encourage citizens to visit health care facilities when the proper care is not readily available. Figure 2-7, illustrates the amount of physicians available per 1,000 people in various countries around the world. An interesting fact to point out is the fact that Cuba is considered a developing country per the CIA World Factbook yet they have a large physician population.

These developing nations drastically need to improve their healthcare systems if they expect to become a developed country in the near future. A better healthcare system could increase the gross national product (GNP), stabilize the population, and promote a stronger economy.

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Figure 2-7: Physicians per 1,000 People

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**Information for figure courtesy of the World Development Indicators Database

Chapter 3: Seismic Risk for Developing Countries Figure 3-1: Haiti Earthquake 2010 Areal View

**Image courtesy of National Geographic

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The most common codes that have been used around the world are the International Building Code (IBC) and the Euro Code. The IBC was developed by the International Code Council in the United States in 1997. It was a collaboration of the Building Officials and Code Administrators International, Inc. (BOCA), International Conference of Building Officials (ICBO), and Southern Building Code Congress International, Inc. (SBCCI). Developed by the European Committee for Standardization, the Euro Code originated in Europe and used accepted by most European countries. Outside of these to codes there does not exist a largely accepted code. In the case of developing countries, if the builder is from the United States or Europe, he/she will use their preferred code, since no other code is legally required.

Therefore, it is common practice to use either the IBC or the Euro Code since they have both been accepted by the general public as good regulations to follow.1

According to the International Institute of Seismology and Earthquake Engineering (IISEE), their seismic design code index lists the following countries as having a seismic code: Albania, Algeria, Argentina, Australia, Austria, Bangladesh, Bulgaria, Canada, China, Chile, Colombia, Costa Rica, Croatia, Cuba, Dominican Republic, Egypt, El Salvador, Ethiopia, European Nations, Germany, Hungary, India, Indonesia, Iran, Israel, Japan, Korea, Macedonia, Mexico, Nepal, New Zealand, Nicaragua, Pakistan, Panama, Peru, Philippines, Romania, Syria, Taiwan, Thailand, Turkey, United States, Venezuela, and Yugoslavia.2 According to this database, approximately 25 out of 172 developing countries, about 14.5%, have seismic codes.

This lack of seismic code in developing countries is heightened by the fact that a good portion of these countries are located in some of the most dangerous seismic zones in the world (See Figure 3-2).

Figure 3-2: Seismic Zones and Developing Countries World Map

**Information for this figure courtesy of the CIA Factbook and the USGS 1 See Appendix II: Interview with Mir Ali 2 International Institute of Seismology and Earthquake Engineering. â&#x20AC;&#x153;Seismic Design Code Index.â&#x20AC;? International Institute of

Seismology and Earthquake Engineering - IISEE. Web. 01 May 2011.

<http://iisee.kenken.go.jp/net/seismic_design_code/index.htm>.

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Chapter 4: Non-Engineered Dwelling Structures in Developing Countries Figure 4-1: 2007 West Smatra Earthquake in Indonesia

Figure 4-2: 2005 Nais Earthquake in Indonesia

**Images courtesy of 2010 Draft Revision: Guidelines for Earthquake Resistant Non-Engineered Construction

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A non-engineered structure is defined as any structure that has been constructed with little or no assistance from an architect or engineer. In many developing countries, this practice of non-engineered structures is fairly common in housing construction.

The reason for non-engineered structures tends to be lack of financial support to pay an architect or engineer. Other times it is the result of no building codes or inspections since the local culture does not emphasize ‘designed’ structures. Therefore, dwelling structure tend to be built out of local, ready-available materials such as stone, brick, concrete, adobe or rammed earth, wood or a combination of these. In masonry building, the mortar is also an easily-obtainable material like cement, lime and clay mud.

The risk to life from these non-engineered buildings is increasing as “population density in these countries, poverty of the people, scarcity of modern building materials, lack of awareness and necessary skills for improved constructions” are on the rise.1 This brings to light another provision that is lacking in most developing countries, lack of hazard safety measures. There are three key elements to hazard safety: risk assessment, emergency plans and emergency prevention. Risk assessment refers to a community’s ability to overcome a natural disaster. This includes building design analysis of existing structures and investigation of existing community response programs. In the event of an emergency, the city, county, state, and/or country should have plans arranged on how to accommodate injured, sick or homeless as well as managing the aftermath of the disaster. As far as emergency prevention is concerned, alarms warning potential disaster threats, such as warning sirens, should be implemented. Other solutions to warn people about upcoming disasters can also be useful such as television or radio alert systems. Educational information about natural disasters and safety measures in case of an event should be readily available at any time. This information should be widely dispersed to warn communities about the potential destruction of such events. Many countries do not have emergency plans set in place for natural disasters or any type of response team organizations. According to the International Decade for Natural Disaster Reduction (IDNDR) Conference of Members of the United Nations and other States, “disaster prevention, mitigation and preparedness are better than disaster response…Disaster response alone is not sufficient, as it yields only temporary results at a very high cost”.2 Thus if the buildings were design to help prevent collapse from seismic forces, a smaller number of casualties would result as well as less financial burden to repair damaged structures.

In 1977, the International Association of Earthquake Engineers (IAEE) created a guideline for seismic design regulation called “Basic Concepts of Seismic Codes”. It was divided into three parts: seismic zoning, non-engineered construction and engineered construction. In 1986, a separate code was printed to specifically focus on nonengineered buildings called the “Guidelines for Earthquake Resistant Non-Engineered Construction”. These codes cover things such as retrofitting existing buildings, engineering without engineers/architects, and causes of failure.

When designing a building in a seismic region, there are certain considerations to understand. The site’s distance from the closest fault line changes the severity of the earthquakes. The closer to the fault line the site is the more disastrous the seismic forces will be. The “inherent strength or vulnerability of the building or structure” has 1 Arya, Anand S. “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction.

”Indian Institute of Technology Kanpur. Web. 03 Feb. 2011. <http://www.iitk.ac.in/nicee/wcee/article/2824.pdf>.

2 Arya, Anand S. “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction.

”Indian Institute of Technology Kanpur. Web. 03 Feb. 2011. <http://www.iitk.ac.in/nicee/wcee/article/2824.pdf>.

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a dramatic impact on the structures ability to withstand the natural disasters.3 The substructure or soil properties of the structure can amplify or diminish the waves from the earthquake. The softer a soil is the more like there is to have damage on the building. This analysis of the seismic region is normally done by experts however, these 3 Arya, Anand S. “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction.

”Indian Institute of Technology Kanpur. Web. 03 Feb. 2011. <http://www.iitk.ac.in/nicee/wcee/article/2824.pdf>.

Figure 4-3: Enclosed Space Diagram

**Figures courtesy of “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction”

guidelines offer some solutions to architecturally incorporate earthquake protection measures into the non-engineered structures. They are as follows: A) Simplicity and symmetry in plan and elevation: If a building is designed symmetrically or in regular geometric shapes, the buildings is likely to have less torsional forces applied to it. As far as elevations are concerned, having even heights Figure 4-4: Suggested Height Restrictions on Building in

Moderate and Severe Seismic Zones

Building Type

Adobe house Field Stone in clay mud mortar Dressed stone masonry in cement mortar Brick masonry in mud with critical sections in cement mortar Brick or cement block masonry in good cement mortar Reinforced masonry Wood frame

Suggested Height

One story or one story + attic One story or one story + attic Two stories or two stories + attic Two stories or two stories + attic

Three stories or three stories + attic

As per design by a qualified engineer Two stories or two stories + attic

**Table courtesy of “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction”

of the walls and symmetrical roofs can help with evenly distributing the forces during an earthquake.

B) Enclosed space: Buildings with smaller rooms without long uninterrupted masonry walls perform better in seismic situations (See Figure 4-3).

C) Opening in walls: A building that has small and centrally located openings such as windows and doors will have larger shear and bending strengths in the walls compared to buildings with large openings.

D) Building Height: The taller a load bearing wall the more damage is likely to occur

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during a seismic disaster (See Figure 4-4).

E) Roofs: Lighter roofs are preferable to heavier roofs in order to decrease its destructive properties in case of an earthquake. The purpose of the roof is to hold the walls in-place and provide shelter. The construction of the roof will allow the structure to act as a diaphragm. If the roof structure acts rigid, as one unit, then it is likely to be successful in seismic conditions.

F) Floors: Floor elements should hold the walls together as well as the roof and the floor should have bearing capacities on the walls to ensure their stability. Rigid floors will perform better than a non-rigid, easily deflecting structure.

The level of seismic structural design measures implemented in a building should depend on the safety level desired. Buildings such as schools, churches, hospitals and other largely populated buildings will require a larger degree of seismic structural strengthening than a small residential home. Largely populated buildings have a higher risk for death in the event of an earthquake and therefore should be treated differently in its seismic structural requirements. For example, hospital buildings should have a higher level of seismic performance so that adequate health care can be administered after the earthquake has occurred. Some factors to keep in mind while designing include the seismic resisting structure are the cost, using local construction methods, and applying very simple, easily taught methods so locals can build the designed system.

Since many developing countries lack the ability to efficiently recover after a natural disaster, it is best to design a building for the absolute worst conditions possible in the building’s region. The earthquake region of the site will have to be found by experts. The building should not suffer any portion of collapse and should not suffer any damage that would warrant rebuilding the structure. In other words, the structure Figure 4-5: Seismic Band Design

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**Figures courtesy of “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction”

should be able to continue its programmatic functions after the earthquake has occurred.

United States building codes are not quite as strict however; the U.S. has the systems in place to handle natural disasters.

Here is a small breakdown concerning masonry and concrete dwellings in developing countries and their applicability to seismic design without engineering. For low-rise masonry houses, the following items should be incorporated into the design: strong mortar, seismic bands, and vertical steel reinforcing. According to Anand Arya in the Non-Engineered Construction in Developing Countries, a mortar with a cement-tosand ratio of 1 to 6 is preferred. Seismic bands can greatly aid in the structures ability to act as one unit instead of multiple members. These bands are normally made out of reinforced concrete or timber depending on which material is more obtainable in the area. There are quite a few different bands that can be used as shown in Figure 4-5, but only a few will be explained for simplicity sake. A lintel band can be considered the most important band. It provides extra strength to a wall wherever there is an opening. Eave/Roof bands are not needed unless the roof system consists of a trusses structure. The plinth band is generally used when the site’s soil is soft and uneven. The plinth band can also solidify the connection between the foundation system and the superstructure to ensure continuous load path transfers to the ground.

In addition to the band implementation and high strength mortar, vertical steel can add another important component to a structure, its ductility. Reinforcing steel can greatly help masonry and concrete walls that are inherently not strong in carrying tensile forces. Not many small housing structures are built out of reinforced concrete but it is important to mention since it tends to be the material of choice for large low rise complexes for multiple families. Normally large buildings use reinforced concrete because it can be expensive to use in developing countries. Some of the problems with the currently existing reinforced concrete structures are they were improperly design without seismic forces and if they are properly designed they are not always built the way they were intended to be. The resulting structures are designed with “wider spacing of stirrups in beams and columns, absence of confining reinforcement in end lengths of columns, absence of stirrups within beam-to-column joints required for shear strength and confinement”.4 Arya offers up details of reinforced concrete that he suggests to help eliminate these problems and allow the concrete to perform better (See Figure 4-6).

Figure 4-6: Reinforced Seismic Concrete Details

**Figures courtesy of “NonEngineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction” 4 Arya, Anand S. “Non-Engineered Construction in Developing Countries – An Approach Toward Earthquake Risk Prediction.

”Indian Institute of Technology Kanpur. Web. 03 Feb. 2011. <http://www.iitk.ac.in/nicee/wcee/article/2824.pdf>.

20.

Chapter 5: Non-Engineered Structures and its Application to Developing Countries

Figure 5-1: 2010 Chile Earthquake

**Image courtesy of â&#x20AC;&#x153;Building Codes Save Lives In Chilean Earthquakeâ&#x20AC;? Inhabitat Article

21.

Techniques for designing buildings in seismic regions in developing countries have many limitations that are controlled either by social or economical influences. Many developing countries do not have building codes and thus do not have any seismic regulations that building owners are expected to follow. The few countries that do have a national building code, lack the ability to enforce it due to other pressing matters or have very limited code standards that will not help in the event of an earthquake.

Some countries lack the materials required, such as cement to make concrete, steel and timber, to reinforce their buildings. Often, they do not have a professional building infrastructure to train people with the skills to design with earthquake forces in mind.

The reason there is such a lack of attention to seismic design in developing countries is because they have more pressing matters. Hunger, poverty, high infant mortality rates, and disease each outweigh the need to design seismic proof buildings.

Due to the extreme financial burden, providing developing countries with all the appropriate materials and training to construct seismically strong structures is not a reasonable goal. It is essential to find a simpler solution to this issue. The greatest concern of buildings in seismic zones is their ability to collapse and cause harm to its occupants. So how do we ensure the safety of these buildings in a socio-economical way? It is essential to understand what material is available, what the local methods of construction are and what local traditions exist in the developing country. After this information is obtained, a designer can start to look at what can be accomplished under the given circumstances in a particular developing country. There are four aspects of seismic design that the “Guidelines for Earthquake Resistant Non-Engineered Construction” suggest in attempting to design a building without engineering1: 1. An ordinary building should not suffer total or partial collapse.

2. It should not suffer such irreparable damage which would require demolishing and rebuilding.

3. It may sustain such damage which could be repaired quickly and the buildings put back to its usual functioning.

4. The damage to an important building should even be less so that the functioning of the activities during post-emergency period may continue unhampered and the community buildings may be used as temporary shelters for the adversely affected people.

To meet the goals of disaster prevention, buildings must be designed to have adequate strength, high ductility, and the ability to remain as one unit even after a very intense earthquake. Existing structures should be evaluated and strengthened to handle any seismic forces that may act on the building.

Four basic effects of earthquakes-induced-damage include ground shaking, ground failure, tsunamis and fire. Ground Shaking is the principle cause of earthquake damage.

When an earthquake strikes, its acceleration, velocity and displacement can affect the buildings structure dramatically. By analyzing the destruction of earthquakes and their impact on previously existing buildings, the design for seismic strength and stability becomes a little clearer. Ground Failure can also cause an increase in earthquake damage. Some prime examples of ground failure include fault zones, landslides, mud slides, settlement, and soil liquefaction. There are many regions of the world that are at high risk for tsunamis and earthquakes. Tsunamis, also known as a seismic sea wave, can cause great damage to buildings due to their great lateral loads they can apply. In 1 International Association for Earthquake Engineering. “Guidelines for Earthquake Resistant Non-Engineered Construction.”

National Information Centre of Earthquake Engineering - IIT-Kanpur-INDIA. Web. 19 Jan. 2011.

<http://www.nicee.org/IAEE_English.php>.

22.

order for a tsunami to occur, there has to be a sudden movement in the ocean floor.

This release of energy under the water causes waves to build. As these waves approach land they decrease in speed but the height of the waves dramatically increase. Once these waves hit the coast, their force is tremendous and can devour buildings with ease.

Fire can greatly heighten the destructiveness of an earthquake hazard. During and after an earthquake, the main priority is to get people to safety. When a fire breaks out, there are few resources available to prevent the fire from spreading or extinguishing it.

Seismic forces are irregular and unpredictable which is why designing a building to resist such forces is not an easy task. When the ground shakes it moves in three different directions all perpendicular to each other. To put it into more mathematical terms, the earth moves along the x, y and z axis. During an earthquake, the building will look as if it has been pushed to one direction when the base of the building goes in the opposite direction. This invisible force that seems to be pushing the buildings is referred to as the inertia force. This invisible push can be explained by Newtonâ&#x20AC;&#x2122;s first law of motion: an object at rest wants to stay at rest. Thus when the ground shakes, the mass of the building wants to remain still but the inertia force is causing it to mass to react. In order to counteract the inertia force, a resultant lateral force forms called the seismic load. This force is similar to a horizontal force acting on the side of a building.

(See Figure 5-2).

Figure 5-2: Seismic Load Force Diagram

**Figures courtesy of â&#x20AC;&#x153;Guidelines for Earthquake Resistant Non-Engineered Constructionâ&#x20AC;?

23.

According to the Guidelines for Earthquake Resistant Non-Engineered Construction, this seismic load, referred to as F in the following equation, can be used for seismic design using the following equation: F = S x Fs x I x C x W S is the earthquake zone factor. This factor can be found on maps to determine the possible earthquake ground intensity in a particular area. Fs is the soil foundation factor. This is a “ratio of fundamental elastic period of vibrations of a building in the direction under consideration and the characteristic site period”.2 Essentially, the soil foundation factor measures the resonance of the building during an earthquake due to the site’s soil quality. The occupancy importance or hazard factor, I, ranks the buildings importance depending on the function that are intended for the building. For example, a hospital or school would have a higher factor value that a single family home because a hospital or school can have a lot of people in it during and after an earthquake. The C factor concerns the structure of the buildings and its stiffness and damping abilities.

“Damping is the energy dissipation property of the building” and stiffness is the buildings ability to resist movement.3 As the stiffness of a building increases so does the factor of C. Damping, however, has the opposite effect. As the damping ability of a building increase the value of C decreases. The total weight, W, of the superstructure, the structure above ground, including anything inside of the building is directly related to the seismic force. As the weight of the building increases the inertia forces acting on the building will also increase causing the seismic force, F, to climb.

If a designer from a developed country wishes to design a structure in developing countries, it is customary for the designer to use the building code they are most familiar with. Often times this is the ASCE 7-05 code. To compare the ASCE 7-05 code and the Guidelines for Earthquake Resistant Non-Engineered Construction equation listed above, it could be said that the ASCE 7-05 is much more in-depth and can often times be more accurate that the equation listed above. This is to be expected however. The NonEngineered Construction equation is to be used by people who have not had education on seismic design or structural design. The ASCE formulas however, are designed with trained engineers and architects in mind. The two methods are greatly alike. Both methods take into account the occupancy of the building, site’s soil classification, weight of the structure, and the buildings ability to resist the earthquake’s lateral forces.

Therefore, it is safe to say that the equation suggested by the Guidelines for Earthquake Resistant Non-Engineered Construction can be considered a good solution to aiding in non-engineered projects.

As discussed earlier, other factors that affect the building’s ability to resist earthquake forces include buildings configuration, opening size, construction quality, rigidity distribution, ductility and foundation design. When a building is designed symmetrically, it can be much stronger that an asymmetric building. Irregular buildings have a tendency to develop torsion which can increase the possibility of damage on the structure. Opening configurations and sizes in walls and floors should be carefully 2 International Association for Earthquake Engineering. “Guidelines for Earthquake Resistant Non-Engineered Construction.”

National Information Centre of Earthquake Engineering - IIT-Kanpur-INDIA. Web. 19 Jan. 2011.

<http://www.nicee.org/IAEE_English.php>.

3 International Association for Earthquake Engineering. “Guidelines for Earthquake Resistant Non-Engineered Construction.”

National Information Centre of Earthquake Engineering - IIT-Kanpur-INDIA. Web. 19 Jan. 2011.

<http://www.nicee.org/IAEE_English.php>.

24.

placed. An opening causes stress concentration that can cause immense force on a very small area. The stress concentrations cause cracking and reduction in strength of the material at that location. This greatly reduces the strength of the entire structure and can cause lethal damage if not correctly designed.

Opening size and the buildings configuration may be inconsequential, if a structure is not built with the proper construction techniques. Poor construction quality can dramatically decrease the buildings strength and performance which drastically increases the earthquake damage. In addition to designing openings, a building’s structural configuration becomes a large factor especially for multi-story structures. If a building’s structural material varies as the buildings rises, loads will not be easily transferred which could increase the potential for damage. Ideally the structure from the very top of a building should continue all the way to its foundations to ensure proper transfer of loads.

This is not to say that the entire building should be completely rigid. It has to have some ductility to withstand the deformations, bending and shaking from an earthquake’s power. Some buildings, especially in developing countries, are built out of brittle materials that lack this ductile quality. Materials such as adobe, brick and concrete can crack, crumble and fail under seismic loads. In order to provide these materials with the desired amount of ductility, steel reinforcement or in some cases timber reinforcement can be added to the structure. Lastly, the buildings foundation can cause a structure to collapse regardless of the superstructure design. Differential settlement, weathering of foundations and soil liquefaction are three factors to consider when designing foundations in seismic regions. Differential settlement is when the substructure sinks down into the soil at different rates causing the substructure to not be level. Weathering of the foundations occurs when the foundations were not designed deep enough to prevent natural forces from coming in contact with them. In cold climates, the foundation structure is must be place below the freeze/thaw line to ensure its structural stability. This means that the connection between the foundation and the superstructure may be larger and will need special attention to secure load paths transfers. As touched on in the first chapter, soil liquefaction can cause an entire structure to topple extremely quickly if the foundations are not properly engineered to counteract this phenomenon.

As the soil around the foundation of a structure becomes liquefied, improperly designed foundations no longer can stay in place and transfer the loads from above to the ground.

For example, if a child has stacked six blocks on top of each other and decided to pull out the bottom block, the entire tower will fall. It’s a similar process when foundations cannot handle soil liquefaction. Foundations built with deep piers or caissons tend to survive soil liquefaction much better than shallow foundations like spread footings or mat foundations.

With this information as well as the local materials, methods and traditions of a developing country, a non-engineered structure could be achieved to withstand seismic forces. This is not to imply that these are the only worries when designing in a seismic zoned developing country. It is a stepping stone, however, in getting a builder to think of all the possible challenges he/she must face. If the builder is not native to the country, he/she needs to develop a system to educate the project laborers to construct the structure properly as well as be courteous to the local environment. A native builder has to convince the locals why he is adapting the local traditions to accommodate seismic construction and to encourage others to build other earthquake resistant structures.

25.

Chapter 6: Seismic Design and Healthcare Conclusions

Figure 6-1: Cabinet Fell Due to Earthquake

**Images courtesy of â&#x20AC;&#x153;Reducing Earthquake Risk in Hospitals from Equipment, Contents, Architectural Elements and Building Utility Systemsâ&#x20AC;?

Figure 6-2: Hospital Storage Falls and Blocks Hallway

26.

Seismic forces dramatically influence healthcare design especially in developing countries where hospitals become main refuge areas after earthquake disasters.

Hospitals are expected to save lives of citizens in a community during emergency situations. If the hospital is unable to function during or after such hazards, the community’s ability to rebound is greatly diminished. The goal of seismic design is to maintain the building’s structural integrity to ensure the function of the building can be carried out after an earthquake. In the last few years, some hospitals have been built in developing countries with widely accepted seismic codes that enable buildings to remain functional after an earthquake. Some of the builders include military forces, nongovernmental organizations and prominent architects from developed countries. OWPP/ Cannon Design designed a “Prototype Hospital” for Afghanistan using the International Building Code 2006 referring to ASCE 7. This one hundred bed hospital is to be built in two rural, seismic locations, Gardez and Ghazni. According to an interview conducted with David Bibbs, assistant principle of OWPP/Cannon Design, and the project’s design team, some of the challenges faced during this project included “customizing a design to meet material availability and their construction and fabrication methods” as well as finding a balance between the existing culture and state-of-the-art design techniques.1 Some obstacles that the design team had to face included the lack of sprinkler systems for buildings, limited access to healthcare professionals in Afghanistan, and multipatient bed ward design. Since Afghanistan is a warring country, similar to many other developing countries, supply renewal, environment security and self-reliant hospital systems were large factors in the construction, operation and maintenance of the buildings. Currently these two hospitals are under construction and are expected to be complete in the near future.

Figure 6-3: Bird’s-Eye View of the Prototype Hospital

**Image courtesy of OWPP/Cannon Design 1 See Appendix 1 for entire interview and design criteria for the Prototype Hospital provided by OWPP/Cannon Design

27.

While analyzing a professionally engineered structure, non-engineered hospitals would have slightly different design criteria to observe. In order to reduce the impact on its surroundings in the event of an earthquake and make construction easy, a one story structure may be a better solution **Image courtesy of OWPP/Cannon Design instead of a multi-story building. A multi-story structure could endanger another building, roadway or people that could cause extreme amounts of casualties and devastation. Regular geometric shapes should be integral in the design for simple fabrication, quick construction and reduction of torsional effects from seismic forces. Geometric shaped hospitals could also help with wayfinding and getting hospital occupants to safety. As in other Figure 6-4: Exterior View of the Prototype Hospital structures, shear walls should be uniformly spaced throughout the building to control lateral forces. Since masonry is a fairly common material available in most developing countries, a masonry wall type should be considered, whether it is constructed of local brick or CMU block. As long as the masonry is reinforced vertically and horizontally and has a strong mortar type, such as type S, the structure should be strong enough to withstand seismic forces.

Steel reinforcement, preferably grade 60, is recommended over timber reinforcing.

Concrete is another solution for developing countries. The ability for concrete to be cast-in-place and reinforced with steel makes it especially efficient to implement. Fiberreinforced concrete has become fairly popular since it performs particularly well in crack mitigation. It may be a good solution for developing countries because the structure would require less maintenance and possibly less repairs after a hazard. If concrete is not readily available in the local setting, it can easily be shipped to the site, assuming it is financially possible. Reinforced cast-in-place concrete should be considered as a material choice for foundations as well as walls. To transfer loads properly to the ground, the foundations should be designed based on the siteâ&#x20AC;&#x2122;s soil properties. If spread footings are the appropriate solution, grade beams should be used to connect the footings instead of tie beams. Grade beams act like regular beams since they can handle tension, compression and moment forces. Tie beams can only carry tension and compression forces. The roof of the hospital should be relatively light and should act as a diagram. A steel or wood truss system would be a possible solution for sloped roof design of a hospital.

In addition to special design considerations, healthcare facilities have special healthcare equipment, architectural elements, bulky furnishings and other non-

28.

structural elements that can render a hospital obsolete if an earthquake damages such components. A healthcare facility’s structure may have survived the earthquake damage-free, however, objects falling on individuals or expensive life-supporting equipment has a greater effect on the hospital’s functionality. With funding from Swiss Reinsurance Company and coordination with the GeoHazard Society in India, GeoHazard International (GHI) has compiled a manual to help hospital administrators maintain healthcare facility operations after earthquake hazards.2 This manual, entitled “Reducing Earthquake Risk in Hospitals from Equipment, Contents, Architectural Elements and Building Utility Systems,” has been distributed throughout India and implemented on existing and new clinics throughout the country. The hope is to have these guidelines incorporated in future building codes and regulations for India and other developing countries in seismic zones. According to this manual the reason for seismic provision in hospitals is due to patients being unable to move to a safe location, staff difficulties in moving critical patients, and the community dependency on the hospital’s operational capacity after an earthquake. The GHI manual is broken down into three sections: “how to identify hazards, how to understand the various options available to mitigate these hazards and lastly, outlines the level of difficulty and estimated cost for each option.”3 The manual has multiple drawings of typical rooms in a hospital that highlight possible hazards and then associates them with possible techniques for mitigation (See Figures 6-5, 6-6, and 6-7).

Figure 6-5: Reason for Anchoring Cupboards

Figure 6-6: Methods of Anchoring for Cupboards **Images courtesy of Reducing Earthquake Risk in Hospitals from Equipment, Contents, Architectural Elements and Building Utility Systems.

2 Rodgers, Janise, Veronica Cedillos, Hari Kumar, L. Thomas Tobin, and Kristen Yawitz. “Reducing Earthquake Risk in Hospitals from

Equipment, Contents, Architectural Elements and Building Utility Systems.” GeoHazards International, 2009. Print.

3 Rodgers, Janise, Veronica Cedillos, Hari Kumar, L. Thomas Tobin, and Kristen Yawitz. “Reducing Earthquake Risk in Hospitals from

Equipment, Contents, Architectural Elements and Building Utility Systems.” GeoHazards International, 2009. Print.

29.

Even though some developing country hospitals are being designed with the latest seismic codes and hospital mitigation guidelines such as those suggested by the GHI, the solution to seismic design of healthcare facilities is still unobtainable. More pressing issues, such as hunger, poverty, disease, etc., need to be resolved before an attempt to decipher the issues of seismic design can occur. This is not a black and white situation.

In order to solve these more urgent matters, a country depends on its healthcare systems to function properly. If the hospitals cannot withstand seismic forces, the healthcare system fails and the ability for a country to overcome its predicament becomes increasingly more complicated.

Assuming that a developing country had the resources and initiative to encourage seismic design, many changes would need to be made within the countryâ&#x20AC;&#x2122;s current situation. Some of these modifications include but are not limited to the implementation of seismic building codes, enforcement of such codes, education of seismic engineering and education of geological hazards such as earthquakes. Therefore, there is no quick solution to seismic design in developing countries. The hope of this paper is to acknowledge the issue of seismic design in developing countries and how it greatly impacts healthcare systems.

Figure 6-7: Methods of Anchoring for Wheeled or Trolley-mounted Equipment

**Image courtesy of Reducing Earthquake Risk in Hospitals from Equipment, Contents, Architectural Elements and Building Utility Systems.

30.

Acronyms: ASHE – American Society for Healthcare Engineering BPHS – Basic Packaged of Health Services CHEF – Construction for Health and Education Facilities (part of USAID) EERI – Earthquake Engineering Research Institute EESD – Earthquake Engineering & Structural Dynamics Journal EWB – Engineers Without Borders FEMA – Federal Emergency Management Agency GHI – Geo-Hazards International IAEE – International Association for Earthquake Engineering IDNDR – International Decade for Natural Disaster Reduction IITK – Indian Institute of Technology Kanpur IOM – International Organization for Migration IPRED – International Platform for Reducing Earthquake Disaster (part of UNESCO) IISEE – International Institute of Seismology and Earthquake Engineering JSPS – Japan Society for the Promotion of Science MCEER Buffalo – Multidisciplinary Center for Earthquake Engineering MDG – Millennium Development Goal MoPH – Ministry of Public Health NEHRP – National Earthquake Hazard Reduction Program NICEE – National Information Center of Earthquake Engineering NGDC – National Geophysical Data Center (part of NOAA) NGO – Non-Governmental Organization NOAA – National Oceanic and Atmospheric Administration PHC – Primary Health Care UN – United Nations UNESCO – United Nations Education, Scientific and Cultural Organization USACE – U.S. Army Corps of Engineers USAID – United States Agency for International Development USGS – U.S. Geological Survey USGS/NEIC – U.S. Geological Survey’s National Earthquake Information Center WCEE – World Conference on Earthquake Engineering WHO – World Health Organization WSSI – World Seismic Safety Initiative

31.

List of Figures: Chapter 1: Figure 1-1: Seismicity Map of South America

1

Figure 1-2: Worldâ&#x20AC;&#x2122;s Tectonic Plates

2

Table 1-1: Modified Mercalli Scale

3

Chapter 2: Figure 2-1: Interior View of Hospital

6

Figure 2-2: Comparison of Developed and Developing Countries

7

Figure 2-3: Developing vs. Developed World Map

8

Figure 2-4: Maternal Mortality Ratio, by Country, of 2005

10

Figure 2-5: Main Factors for Afghan Girls to Not Attend School

11

Figure 2-6: Total Fertility Rate of Country

11

Figure 2-7: Physicians per 1,000 People

13

Table 2-1: Millennium Development Goals

9

Chapter 3: Figure 3-1: Haiti Earthquake 2010 Areal View

14

Figure 3-2: Seismic Zones and Developing Countries World Map

15

Chapter 4: Figure 4-1: 2007 West Smatra Earthquake in Indonesia

16

Figure 4-2: 2005 Nais Earthquake in Indonesia

16

Figure 4-3: Enclosed Space Diagram

18

Figure 4-4: Suggested Height Restrictions on Building in Moderate and Severe

18

Seismic Zones Figure 4-5: Seismic Band Design

19 32.

Figure 4-6: Reinforced Seismic Concrete Details

20

Chapter 5: Figure 5-1: 2010 Chile Earthquake

21

Figure 5-2: Seismic Load Force Diagram

23

Chapter 6: Figure 6-1: Cabinet Fell Due to Earthquake

26

Figure 6-2: Hospital Storage Falls and Blocks Hallway

26

Figure 6-3: Birdâ&#x20AC;&#x2122;s-Eye View of the Prototype Hospital

27

Figure 6-4: Exterior View of the Prototype Hospital

28

Figure 6-5: Reason for Anchoring Cupboards

29

Figure 6-6: Methods of Anchoring for Cupboards

29

Figure 6-7: Methods of Anchoring for Wheeled or Trolley-mounted Equipment

30

Appendix: Figure A-1: Prototype Hospital Courtyard

a-1

Figure A-2: The cover of The Skyscraper and the City: Design, Technology and

a-9

Innovation by Mir Ali Figure A-3: the cover of Art of the Skyscraper: The Genius of Fazlur Khan by Mir Ali

33.

a-9

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Appendix I: Interview with David Bibbs

Figure A-1: Prototype Hospital Courtyard

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**Image courtesy of OWPP/Cannon Design

In 2009, Cannon Design and OWPP merged to create one of the largest architectural engineering firms in the United States. With over 1,000 professionals on staff and 17 regional offices, the firm is able to conquer multiple markets, work international and provide multiple services in house.

David Bibbs is an Assistant Principle at OWP/P l Cannon Design and leads the structural engineering group in the Chicago office. His experience includes work in all markets however, he has a strong emphasis in education and healthcare structure.

International Organization for Migration (IOM) and United States Agency for International Development (USAID) approached OWP/P l Cannon Design with the challenge to design two 100 bed hospitals in Afghanistan. The purpose of these buildings is to increase the availability of urgent care facilities in a country whose healthcare system is dramatically underdeveloped. The two locations chosen for this project are Gardez and Ghazni which are about 80 miles outside of Kabul. Each of the 115,000 square foot hospitals is to have the following departments: and emergency department, surgery, imaging, laboratory, obstetrics, pharmacy, rehabilitation, outpatient services, dental and various support facilities.

The interview was conducted via e-mail. A list of questions was send to Mr. Bibbs and responses were sent back a week later. The answers on the following pages are the responses from the architectural team in red and the structural team in blue. In addition to answering my interview questions, Bibbs graciously included the structural design criteria used on the project.

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Seismic Design in Developing Countries Interview 1. How does the process of designing (structural and/or architectural) in a developing countries differ from that of a domestic design?

It is much more difficult to get information on the site, the program, and the real needs of the users of the project. We had no access to any clinical professionals, which takes the design process in a very different direction. The interactions are very narrow, and focused on who is able to attend Skype calls. It’s designing through a straw.

Also, the design codes and parameters, materials, and construction methods all need to be thoroughly researched before selecting proper systems.

2. What part of structural design in Afghanistan/Developing Country is the hardest to overcome?

There are several but customizing a design to meet Material Availability and their construction and fabrication methods while still providing a safe and reliable structure is probably the hardest.

3. What part of architectural design in Afghanistan/Developing Country is the hardest to overcome?

Finding the right fit culturally. “Culture” in the sense of their construction practices/ economics, clinical operations, and religious practice. Overlaid on that is the desire to push the envelope on all these fronts, but by the “right” amount to not overburden its feasibility. How “American” should the building be? They hired us for our expertise, but it must be Afghan ultimately. So drawing that line was challenging.

4. How difficult is it to accommodate local construction and engineering practices?

It’s difficult, but it always helps when the client or the contractor have a local presence.

Some issues were hard to reconcile; they do not sprinkle their buildings, so we had to find a fire protection scheme based on separations. They do not do storm water management, that was hard for the civil engineers. The actual building typology (concrete load bearing masonry) was a very familiar system to us, so that went smoothly.

5. What cultural differences in health care design did OWP/P l Cannon Design face?

The multi-patient bed ward was new to most of our team. US hospitals are going from 2 to 1 patient per room, due to better infection control, and improved lengths of stay that 1 per room provides. Designing for 4-6 patients per room is a very different set of clinical priorities; they need to maximizing resources with a different definition of “resource” than ours. They are trying to leverage very basic care with very few staff.

6. What are some of the possible seismic systems that can be implemented in Afghanistan?

CMU or Concrete shear walls, with concrete probably being the best option. For larger projects steel frames can be imported from Turkey.

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7. What are some of the possible seismic systems that can be implemented in Developing Countries?

Cast in place site mix concrete shear walls or any other type that can be imported to the site.

8. For seismic design of a one-story masonry building, what are some factors to keep in mind in order to make the structure more resistant to seismic forces?

A proper distribution of shear walls and a good diaphragm with good connections to it. a. How do window and door placement, size and shape play a role in the seismic performance of a masonry building? This affects drift and relative stiffness of the shear walls. A proper balance in your building can avoid differential deflection of shear walls and avoid having incidental loads on your diaphragm. b. What techniques can be used for crack mitigation in seismic areas? There are several, but fiber reinforcement is becoming very popular.

9. What resources were used to decide the severity of earthquake hazard in Afghanistan?

USGS in cooperation with USAID and IRD prepared Earthquake Hazard maps for Afghanistan http://afghanistan.cr.usgs.gov/hazards.php. The maps can be found here http://pubs.usgs.gov/of/2007/1137/. At times we also use information from the Department of Defense Unified Facilities Criteria (UFC) http://www.wbdg.org/references/ pa_dod.php. a. Section in the code used?

We used US codes because the project was funded by USAID, and because Afghanistan does not have any building codes or guide lines available. b. Earthquake engineering organization results?

10. What companies, NGOs or organizations are the leaders in designing/engineering in developing countries? a. National Information Center of Earthquake Engineering? b. International Association for Earthquake Engineering? c. World Health Organization? d. USAID e. UN f. International Relief & Development, Inc. 11. Are the IAEE “Guidelines for Earthquake Resistant Non-Engineered Construction” and the “Guidelines for Earthquake Resistant Engineered Construction” obsolete?

We did not use these guidelines 12. What types of computer programs are used in practice today to analyze seismic performance?

Most software packages have some sort of seismic component built in, but they typically only work well for steel or concrete. For CMU we used Ram Elements and Risa 3d, with Risa 3d working the best with openings.

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Prototype Hospital Prototype Hospital Questions: 1. What seismic codes were used to design the hospital?

See Design Criteria on adjacent page.

2. What health care codes were used for the hospital?

AIA Guidelines for Design and Construction of Healthcare Facilities 2006, although we had to make several key exceptions, and document why they could not meet some of the provisions.

3. Did you have to make provisions to these codes per the local culture? a. or per issues with material? b. or per issues with war conflicts near the site?

Other than the perimeter wall and entry guard station, they did not want any ballistic design features.

4. How did the current war impact your design and/or construction of the hospital?

The biggest impact was the requirements resulting from un-reliable truck traffic and resupply. We needed a 3 month supply of fuel for example. The hospital had to be more self reliant due to the security environment.

5. Would OWP/P l Cannon Design consider doing another project similar to this one?

Yes. We learned a lot about designing in this context. We would like to leverage that knowledge.

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Appendix II: Interview with Professor Mir Ali

Figure A-2: The cover of The Skyscraper and the City: Design, Technology and Innovation by Mir Ali

**Image courtesy of Amazon.com

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Figure A-3: The cover of Art of the Skyscraper: The Genius of Fazlur Khan by Mir Ali

Since 1989, Mir Ali has been a professor in the structural design department at the School of Architecture at the University of Illinois - Urbana Champaign. He is currently the Chair of the Structures Department and coordinates the program for structures option MArch students. Mir Ali will be retiring from the University in May but will continue to teach at the on a part time basis. As an professor emeritus, Ali hopes to publish more of his recent research as well as continue to help students enhance their education.

Ali is a licensed structural engineer in Illinois and has worked for some of the top engineering firms such as Skidmore, Owings and Merrill and Sargent & Lundy. Some of his recent publications include but are not limited to “Integrated Design of Safe Skyscrapers: Problems, Challenges, and Prospects,” Proceedings of the CIB-CTBUH International Conference on Tall Buildings (2003), Catalyst for Skyscraper Revolution: Lynn S. Beedle—A Legend in His Lifetime (2004), The Skyscraper and the City: Design, Technology, and Innovation (2007).

Mir Ali received his Bachelor of Science from the University of Engineering and Technology in his native country of Bangladesh in 1964. In order to enhance his career as a structural engineer and broaden his horizons, Ali traveled to North America. In 1977 he received his Doctor of Philosophy at the University of Waterloo in Ontario, Canada.

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Seismic Design in Developing Countries Interview 1. What seismic design codes are used today to build in developing countries? a. Does it vary depending on who the architect/engineer is? i. i.e. what country they are from 1. United States vs. Europe 2. IBC vs. Eurocode Most people designing in developing countries will refer to the IBC as the code. Some Europeans may use the Euro-code because that’s what they are used to. The IBC however, is the predominating code since it refers to the ASCE-7. The United States has a lot of money invested in building and materials research; therefore the US tends to be the leader in design code. This is partly why Mir Ali came to America for his studies and research.

Side note about Afghanistan: “Afghanistan is a very inward looking country. They are stuck in the middle ages”.

There is no building commission or any governmental body that regulates building and design codes. ACI codes for reinforced concrete and similar concrete structures would be the predominating sub-code used in developing countries as well.

2. Since typhoons tend to coincide with earthquakes, how does designing for typhoons compare to seismic design?

When designing for Typhoons/Cyclones/Hurricanes, the main factor is the lateral wind loads that will be distributed onto the structure. In an Earthquake, the main factor is the acceleration caused by the seismic forces. Therefore the structures ductility becomes an issue. In Typhoon situations, the structure does not necessarily have to be ductile but as long as it can resist the later loads. A seismic region needs buildings with high ductility. Ductility can be loosely measured by mass multiplied by acceleration.

Mass is not a factor in lateral load resisting in typhoon prone areas.

3. I am particularly interested in Healthcare design in developing countries and their seismic design parameters. Any suggestions? a. Any codes relating to healthcare design that would help?

He would assume that the “Guidelines for Design and Construction of Health Care Facilities” would be the leading regulations in this situation however he suggests I talk to leading professionals such as Dave Bibbs concerning this question.

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7. Throughout my research I have noticed that there is a lot of information on seismic design in developing countries but it is very sporadic. Are there any sources that you recommend?

There is a lot of information out there but since it keeps changing and is fairly new.

Hence my troubles. He walked me through how do mathematically design a structure. i. Equivalent Lateral Force Procedure 1. First find the peak acceleration numbers (normally in a chart) a. difficult to find b/c normally given to by a soil engineer b. According to the US Army, Max Considered Earthquake (MCE) for Afghanistan: i. Ss = 1.28g ii. S1 = .51g iii. Ss â&#x20AC;&#x201C; short period of acceleration iv. S1 â&#x20AC;&#x201C; period of acceleration of one second v. This is Site Class B **If you do not know the site class or soil condition you are to assume Site Class D** 2. Calculate Lateral Loads a. Refer to Occupancy Types, Seismic Design Categories b. Get the dead and live loads c. Find the bending and shear forces d. Check the reinforcement requirements e. Find the sufficient ductility needed for the structure i. Special moment resisting frame??

3. Detail the joints 4. Foundations a. if you have spread footings you need to connect them with either tie beams or grade beams i. tie beams = take compression and tension (not recommended) ii. grade beams = act like regular beam, have moment/rigid connections, Recommended

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