* 70% of Latin American hospitals are in a region particularly vulnerable to floods, earthquakes or hurricanes

* 550 floods hit the region between 2000 and 2019, causing nearly $ 26 billion in damage

* Changes now to build resilience and avoid flood damage are cost effective, experts say

SAO PAULO, March 9 (Thomson Reuters Foundation) – Last December, when doctor Victor Heitor Gomes became director of health for Rafard, a municipality 150 km northwest of São Paulo, he knew he faced challenges ahead.

The only clinic in the city of 9,000 has weathered tough times: heavy rains in mid-November caused part of the conference room walls to collapse and a month later more rain inundated parts of the building, including the operating room and public areas.

The problem forced the clinic to move some services to another room – and repairing a one-meter hole in the meeting room wall had to be postponed due to continued rain in Brazil’s summer.

Heavier rains and increasingly scorching temperatures have made life difficult for doctors in other ways too, said Gomes.

“They change the season for certain diseases. “You don’t expect to see dengue fever in winter, but it’s becoming more and more common now,” he said.

Extreme weather, such as the floods that swept through the Maria Tereza Apprilante Gimenez Primary Health Care Unit in Rafard, is increasingly becoming a region-wide threat as climate change continues – and creates additional burdens for health workers struggling to combat the coronavirus pandemic.

According to the Pan American Health Organization, nearly 70% of the 18,000 hospitals in Latin America and the Caribbean are located in areas highly prone to flooding, major earthquakes or hurricanes.

Inundation is the most common threat. Nearly 550 floods hit the region in the two decades between 2000 and 2019, affecting more than 40 million people and causing nearly $ 26 billion in damage, according to a 2020 report from the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA).

Brazil is the most flood-prone country in Latin America, the report said.

HEAVY RAIN

The storm that hit Rafard also worried nearby São Paulo, the largest city in Brazil and in South America.

The concrete-filled urban area acts as a “heat island” that absorbs and then slowly releases solar heat, making it hotter than the surrounding rural areas.

In cities like São Paulo, that extra heat combines with the moisture coming from the nearby Atlantic Ocean to create heavier rains, said Tércio Ambrizzi, an atmospheric scientist at the University of São Paulo.

“Heat lifts and condenses moisture, making it rain,” often more intense than is possible elsewhere, said the scientist, who co-authored a 2020 study of changing rainfall patterns in metropolitan São Paulo between 1930 and 2019.

Using data from Brazil’s National Meteorological Institute, the researchers found that heavy rains become more concentrated in shorter periods, while dry seasons are longer.

The changes have been very visible over the last decade, they said.

In 2014, Sao Paulo’s hottest summer in seven decades, reservoir water for the city fell below 20% capacity, in a record of the city’s biggest water crisis and a serious threat to health care facilities.

Very heavy rainfall events – the kind that can trigger disasters – have nearly doubled in the last decade compared with 1971-1980, the researchers found.

Extreme conditions are most visible in Brazil’s southern and southeastern regions, and are a particular problem for densely populated cities such as Rio de Janeiro and Porto Alegre, which are particularly prone to flooding and landslides in part due to poor urban planning, Ambrizzi said.

FRONT PLANNING

Eduardo Trani, sub-secretary of the environment for the state of Sao Paulo, said his office was aware of the challenge.

A 2009 law passed by the state establishes policies to curb greenhouse gas emissions and adapt to climate threats, including efforts to map climate risk in all 645 cities in the state.

Nearly 250 have been completed so far.

“This mapping is adapted to an environmental scale, so that the local town hall can study preventive measures to deal with floods and landslides,” said Trani.

So far the results found are that basic health care units, especially in the metro area of ​​São Paulo, are often in flood-prone areas or are surrounded by them.

That can be partially mitigated with infrastructure changes, such as building flood walls around hospitals and moving vulnerable ventilation, heating and air conditioning systems to higher ground, resistance experts say.

Having spare resources – including solar panels or other renewable energy – can also keep hospitals functioning when the broader power system goes down in extreme weather.

Mariana Silva, infrastructure and sustainable finance specialist at the Inter-American Development Bank, says building resilience is also a planning issue for the next few decades.

“If a hospital is to be built in a place that is very prone to disasters, we have to ask ourselves what we can change in terms of the technique. You’d be surprised how small changes can make a project resilient, “he said.

A design shift could add to costs – but ignore the risk that it would be more expensive, he said.

“Making that change costs extra – but now Latin American governments know that climate change is not an ‘if’ but a ‘when’ problem,” he said.