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EMERGENCY FACILITIES


FÁBIO BITENCOURT, DORIS VILAS-BOAS, EMERSON DA SILVA – ARCHITECTS, BRAZILIAN ASSOCIATION FOR THE DEVELOPMENT OF HOSPITAL BUILDING (ABDEH)


Emergency healthcare architecture in Brazil


This article by the Brazilian Association for Development of the Hospital Building (ABDEH) presents a summary of real-life installations and new design concepts for COVID-19 response emergency hospital buildings to satisfy the needs of each of the country’s five geopolitical regions.


COVID-19 has hit Brazil hard since the first case was confirmed on 26 February 2020, with more than 80,000 deaths recorded just four months later in July. During that period, important changes in the lives of the inhabitants of Brazil led to discussion about facilities in the Brazilian Health System (SUS): the training of health workers, evaluation and adaptation of healthcare facilities, as well as the necessary and available equipment. As a result, it fell to the Brazilian


Association for the Development of Hospital Building (ABDEH) to examine new solutions for emergency healthcare buildings in the wake of COVID-19. ABDEH is a civil society entity composed predominantly of architects, engineers


and other professions that conducts research work into healthcare facilities in Brazil. The summary of research work carried


out for COVID-19 presented below outlines the experiences of architecture and engineering in the construction of emergency hospitals, as well as other adjustment, retrofit and adaptation solutions in existing buildings. The aim was to find solutions for each of the country’s five geopolitical regions: North, North-east, Midwest, South-east, and South. For the studies, existing documentation


and technical recommendations from the Ministry of Health were used, as well as guidelines published by the International Federation of Healthcare Engineering


(IFHE) and the World Health Organization (WHO).


Brazilian experiences In the Brazilian health system, it is possible to identify different buildings for Health Assistance (EAS) dedicated specifically to the treatment of people affected by COVID-19: l Hospitals that care exclusively for the patient with the disease: • Existing units converted to service • Units built temporarily for assistance


l Hospital for general disease care including COVID-19.


Fábio Bitencourt Doris Vilas-Boas Emerson da Silva


•Fábio Bitencourt is an architect, professor and member of the Executive Committee of the International Federation of Healthcare Engineering since 2014. An author of various books and publications on hospital architecture, human comfort, healthcare environments and ergonomics, Fábio is also a member of the Brazilian Academy of Hospital Management (ABAH), a member of International Academy for Design and Health (Design & Health) and leader of the South America Chapter. He is also a past President of the Brazilian Association for the Development of Hospital Building (ABDEH). •Doris Vilas-Boas is a vice-president of the Brazilian Association for the Development of Hospital Building (ABDEH), active in the area of healthcare network planning. Doris is also a specialist in health systems architecture at the Federal University of Bahia (UFBA), PAHO/WHO consultant for the Ministry of Health, and researcher at the Hospital Engineering and Architecture Study Group at UFBA. •Emerson da Silva is the vice-president of institutional relations at the Brazilian Association for the Development of Hospital Building (ABDEH) and served as the organisation’s President between 2017 and 2020. An architect, Emerson is a specialist in biosafety. Emerson is also a former President of the Brazilian Congress for the Development of Hospital Buildings.


IFHE DIGEST 2021


In most Brazilian hospitals, a crisis committee was set up with professionals from management, assistance and technical areas, such as architecture and engineering. The main concerns were related to changes in external and internal flows, the creation of beds dedicated to COVID-19, the mapping and or the acquisition of new equipment and identification of the need to provide changes in the air conditioning system. The first adaptations of Brazilian hospitals that were organised to care for patients with COVID-19 were: the creation of external environments for screening potentially infected patients, separation of flows between different patients and also the separation of access by the assistance team; and zoning of inpatient areas, defining exclusive areas for infected patients. Another fundamental item was the organisation of the areas for laboratory and imaging examinations. Due to its territorial extension and because it is a country with great climatic diversity, the Technical Standard for Thermal Performance of Buildings of ABNT (Brazilian Association Technical Standards) breaks the country down into eight distinct regions.1


In some of these


regions it is cold and, at the same time, in others it is very hot. One of the main aspects relating to pathology and ventilation conditions for


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