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EMERGENCY FACILITIES


the natural ventilation and ensuring inward flow to the patient rooms. The team considered how both patients and staff flow through the facility—we designated separate staff areas to ensure protection of the staff while minimising the need for PPE. The team adapted the facility using a WHO guide, planning for both mild and severe patients, addressing ventilation, patient and staff flow, protection of staff, laundry, and medical waste disposal. We feel incredibly fortunate to have had this opportunity - for Mazzetti to be able to invest our time in research of COVID-19 and develop ventilation recommendations for our hospital clients in the US and now globally. We are using this knowledge and our experience in healthcare ventilation to help facilities anywhere, threatened by this virus, including those without the tremendous healthcare infrastructure that we have in the U.S.


Haiti project – June 2020 As reported in the New England Journal of Medicine,1


COVID-19 cases have been


reported in all 10 departments of Haiti. As of 2 June 2020, there were more than 2500 confirmed cases and the doubling time was five days.


Haiti has one of the highest mortality


rates from natural disasters in the world. The same factors that contribute to deaths from natural disasters, make Haiti susceptible to a viral pandemic: poverty, food insecurity, lack of clean water and sanitation, scarce health care resources, low educational attainment, political division, and densely populated slums that are controlled by gangs and inaccessible to public officials. Lessons learned in Haiti will be applicable in other low-income countries with similar vulnerabilities. The second project was catalyzed by the need in Haiti for screening facilities. This project was not site-specific, rather,


focused on the need for designing prefab screening facilities with, per the WHO’s request, the ability to “expand” as needed. Mazzetti partnered with architecture firm TreanorHL. This effort was directly coordinated with the United Nations Humanitarian Response Depot (UNHRD). The team essentially provided guidance


for designing modular screening facilities with the ability to scale to different sizes. In Haiti, specifically, the design guidance was applied to pre-existing modular facilities, remaining from a post-hurricane relief effort. The teams advised that the screening


facility should be a collection of modular units that can be easily site assembled and used individually or combined into larger enclosed and conditioned spaces. The arrangement of these modules serves the flow of patients and a larger overhead


28


Original maternity facility in Burkina Faso.


shade structure will be provided for unconditioned areas for waiting and to maintain physical distance. The modules may rest on legs and so a


raised walkway or platform may be used to provide a roughly uniform walking surface.


While the modules are designed to


resist wind, methods such as anchors or ballast will be required to hold them down in windy or seismic conditions. While Haiti is prone to both hurricanes and earthquakes, a specific site has not been selected and the building code has not been specified. Therefore, determination of wind or seismic design criteria has not been started. The overhead shade structure could


take the form of a rigid structure using steel, aluminum, or wood, with a hard roof. Alternatively, the shade structure could be composed of a fabric stretched over a tent-like framework. The selected system should balance low initial cost, while being durable (relative to the lifespan of the facility), easy to erect using local manpower, expandable and potentially demountable for reuse at another location.


Knowledge sharing & mentoring Later, Team 1 became an advisor to other international teams (among the 16 formed), with the goals of multiplying the capabilities of WHO staff and sharing experiences to shorten the design process for new teams. The team learned to work with limited


information, communications constrained by time zone, language, and multiple layers between design team and in- country staff. Many of the rules we know from our experience in the US simply do not apply in areas with severely limited


resources, where natural ventilation is the norm and power may not be reliable. As of this publication, IFHE members and partners are mentoring projects in both Brazil and Ethiopia with varying scopes. A full report on the Haiti screening facilities can be viewed at https://indd.adobe.com/ view/00f189f9-09bc-400d-b7af- 106286c5e52b.


Accra ventilation design analysis The IFHE ventilation team, comprised mostly of Team 1 engineers, was also asked to assess the ventilation design of a new tent hospital to be constructed in Accra, Ghana. A computational fluid dynamics (CFD)


assessment was completed to provide illustration and understanding of the airflow movement within the space, with the intent of creating a cleaner environment for medical staff. The patients in this case were patients with mild COVID symptoms. The team assessed the airflows


produced from the air-conditioning systems, as well as air extracted behind the patient beds and recirculated into the space via HEPA filter systems. The team analyzed the air volumes,


velocity, directions, and temperature to help determine any modifications required for better ventilation to the space. Based on this, the team advised on how to redesign the HEPA (high- efficiency particulate air) filter system and reposition the extract grilles to provide better airflow from the patients towards the extract, providing a better distribution of air throughout the space. Using CFD modeling, the team


determined that some simple modifications could improve the


Modular screening facility design for Haiti. IFHE DIGEST 2021


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