Mitigation Success Stories

The U.S. Territory of Guam is the largest and southernmost island in the Mariana Islands archipelago. It is located in the western Pacific Ocean, south of Japan. The island of Guam, while only 209 square miles in size, is densely populated (140,000 residents). Many tropical storms, known as typhoons, form in the western Pacific Ocean. In the past 50 years, more than 25 typhoons have struck the island.

Guam is also in a highly seismically active zone. The strongest earthquake to hit the island in recent times was of magnitude 8.3, which violently shook the island in 1993.

On December 16-17, 1997, Typhoon Paka, noted as one of the most powerful storms of the 20th Century, directly struck the island of Guam with sustained winds of 150 miles per hour and gusts to 185 mph. Of notable importance, Paka's winds impacted the island for a full 12 hours, creating a much longer than usual timeframe for wind, rain, and storm surges to cause damage. The northern and central sections of the island sustained severe and widespread damage to homes, the island's power distribution grid and public utilities, privately owned buildings, and many other structures.

Guam Memorial Hospital (GMH) is the only civilian inpatient facility on the island. GMH is the only healthcare facility that remains open during and immediately after typhoons. As such, GMH becomes the only dialysis unit, the only lab and the only source of oxygen. It also provides temporary lodging for expectant mothers until it is safe for them to return to their homes.

Typhoon Paka impacted GMH's main building and its service delivery. The exterior oxygen storage facility sustained some structural damage from the intense winds. Upper levels of the hospital are accessible by an open stairwell and exterior corridors. Heavy rains and extremely powerful sustained high winds generated by Typhoon Paka created an extremely dangerous situation that made the ability to care for the patients on the upper levels difficult and limited. Clean up of this area after the typhoon was time consuming and added to the hazard.

Because of the critical service it provides to the community, and because of the high frequency of natural disasters, GMH is very proactive with respect to its preparedness and mitigation programs.

In the early 1990s, GMH's administration analyzed labor expenses following major typhoons that occurred. Their findings showed that extraordinary expenses from effects of Typhoon Yuri in 1991 totaled $145,168 and for Omar in 1992 was $159,688. Based on utilization of employees and actual costs incurred, a new staffing plan for deploying and rotation of staff was developed. This new plan was enacted for Typhoon Paka in 1997.

Following Typhoon Paka, GMH was awarded HMGP funds to harden the oxygen storage facility and enclose the exterior corridors and stairwells. By replacing the facility's tin roof with concrete and by building concrete walls around the structure, the hospital eliminated the possibility of storm and debris exposure to the facility and its contents. In addition, HMGP funds were also provided to enclose the exterior corridors on the ground floor and the exterior stairwell in order to provide a safe, protected means of access between the ground floor, the 2nd floor emergency room, and the inpatient units on the 3rd and 4th floors.

Post disaster analysis showed that the cost of personnel using the new staffing plan, was $97,999 -- a 39 percent reduction in actual extraordinary costs for personnel for Typhoon Omar. Benefits of the staffing plan implemented for Typhoon Paka were that the majority of staff worked regular hours, overtime was reduced, and the relief crew was well rested, thus better able to handle the post-disaster influx of casualties.

The one-time cost of replacing the roof of the oxygen storage facility and the liquid oxygen tank, and for using portable cylinders until the new tank was put in place, was $988,560. The cost of hardening the oxygen storage facility was $51,550. The benefit/cost ratio for this project is 20:1. The expectation is that there will be none or minimal damage from the next typhoon and thus no further repair or replacement costs.

The cost to enclose exterior corridors and stairwells was $1,868,062. Federal funds for mitigation of the corridors and stairwells was $1,721,671. Risk analysis shows the benefit of this work is valued at $4,768,188, a benefit to cost ratio of 2:6.