Scaling infrastructure during health emergencies
UNICEF supplements government health systems with rapidly scalable facilities to prevent disease and care for children and communities.
In many countries, the COVID-19 pandemic quickly overwhelmed healthcare systems and left them unable to cope with the sudden surge of critically ill patients. In response to the pandemic, UNICEF launched the most extensive and complex emergency operations in its history which included support in construction of health facilities to help save lives.
Emerging diseases and health crises require innovative solutions to prevent transmission and treat patients. UNICEF maintains up-to-date global and country-specific emergency preparedness plans based on country- and region-specific hazards. Preparedness ensures that UNICEF is ready to respond with appropriate and effective supplies and equipment, no matter where or when a new health crisis occurs. The preparedness mindset also allows UNICEF’s support to evolve quickly as new threats or disease transmission patterns emerge.
“UNICEF’s preparedness planning efforts help us identify potential public health emergencies and arrange for the rapid deployment of necessary supplies, including equipment and materials for construction, to assist countries in responding and recovering from disease outbreaks and other health emergencies.”
UNICEF’s construction interventions UNICEF’s construction interventions are critical when it comes to a health emergency response – both in preventing the spread of infection and in rapidly scaling up the capacity of health systems to provide care and treatment.
Year-round preparedness in construction
UNICEF provides construction solutions that enable governments and communities to repurpose existing spaces or build new temporary facilities to address a health crisis. In past Ebola disease outbreaks, UNICEF supported the building of isolation centres in West Africa that helped contain disease transmission and supported the health workers in providing patient treatment.
While much of UNICEF’s construction work supports an emergency response already in progress, UNICEF country teams work year-round in emergency preparedness. For example, UNICEF streamlines procurement and contracting processes so they can be activated quickly when needed. UNICEF country offices establish long-term agreements (LTAs) with pre-approved local building contractors so that when emergencies happen, construction services can be signed on immediately.
Bringing COVID-19 resources to hospitals in Burundi
Historically, Burundi’s health system has been very centralized. As a result, populations who live outside major urban centres must travel long distances to access healthcare from district-level hospitals.
As part of the COVID-19 response, UNICEF helped to build triage and isolation blocks at community-level health centres, which in turn helped enable patient care at the local level. Triage blocks were equipped with medical examination rooms. Isolation blocks typically contained 13 beds, bathrooms, and three outdoor hand washing points. In total, UNICEF supported the building of 24 blocks in eight hospitals. In four of these upgraded hospitals, the new blocks were connected to solar panels to create a reliable, sustainable source of electricity.
In addition to serving local communities during the pandemic, these blocks contribute to a nationwide effort to decentralize healthcare in Burundi by making quality care more accessible to local populations.
Isolation and treatment centres made from bamboo in Cox’s Bazar Refugee Camp
Located in Cox’s Bazar, Bangladesh, Kutupalong refugee camp is the world’s largest refugee camp, inhabited by Rohingya refugees who brought with them accounts of the unspeakable violence and brutality that had forced them to flee.
Poor sanitation conditions and lack of space for isolation presented a major risk for the Rohingya and host communities during the COVID-19 outbreak. As a solution, UNICEF used locally available bamboo to construct a new severe acute respiratory infection (SARI) isolation and treatment centre.
Bamboo is a cost-effective material and presents an alternative to tents which would have to be ordered from outside the country and may have faced delivery delays given prevailing global logistics challenges during the pandemic. Since bamboo is available locally and no heavy machinery is needed in bamboo construction, the transportation costs and the carbon footprint related to construction are comparatively low. The expertise of the local workforce in building with bamboo also resulted in a positive social impact on the community through the creation of employment opportunities.
The facility, which includes a zone for patients suspected or confirmed to have COVID-19, took five months to construct. It provides 240 beds, a triage area and lab, a separate zone with a doctors’ room, staff room, meeting rooms, a canteen, kitchen, an oxygen generator, a waste zone with waste store, an incinerator, a morgue and a WASH area with a water tank and borehole.
Community Care Centres during the Ebola crisis
Between 2014 and 2016, during the unprecedented scale of the Ebola outbreak in West Africa, the lack of treatment beds for patients required an urgent solution. The construction of Community Care Centres (CCCs) was one of the approaches implemented by UNICEF and its partners to support access to isolation and care at the community level. The CCCs are based on comparatively inexpensive, low-tech, temporary structures that could be set up in affected communities to isolate patients with suspected Ebola virus disease and provide them with supportive medical care. In all, UNICEF and implementing partners constructed 46 CCCs across Sierra Leone, Liberia and Guinea.
Construction innovation for future emergencies
Recent infectious disease outbreaks such as Ebola and COVID-19 have highlighted the urgent need for rapidly deployable surge facilities that enable health workers to screen, isolate, and treat patients. UNICEF, the World Health Organization (WHO), and Médecins Sans Frontières (MSF) are collaborating with the private sector to develop a modular Health Emergency Facility that can be rapidly equipped for deployment in future health emergencies.
“Recent outbreaks such as Ebola and COVID-19 have been the driver of innovation for health emergencies.”
The Health Emergency Facility (HEF) will include all components required for screening, isolation, and treatment, including the physical structure, medical equipment and medicines. Each HEF will generate its own electricity supply and include access to safe water. The modular units are based on UNICEF’s innovative High Performance Tent (HPT). Depending on the community’s needs, they can provide additional surge capacity to support existing health facilities or be installed as a standalone health emergency facility.
“Recent outbreaks such as Ebola and COVID-19 have been the driver of innovation for health emergencies. The HEF is the result of a successful collaboration with UNICEF’s tent suppliers and partners at WHO and MSF, developing construction solutions in preparation for the next outbreak,” said Heta Kosonen, Project Specialist with the Product Innovation Centre at UNICEF Supply Division.
During the onset of the COVID-19 pandemic, health facilities could take months to plan, install, and operationalize. The HEF is designed to be set up in just weeks, as speed is critical to help contain the spread of infection.
Outbreak response is an important component of UNICEF’s broader programming in construction for health. The UNICEF Strategic Plan, 2002-2025, highlights children’s health in Goal Area 4.