Mediclinic Vergelegen Flood November 2013

Mediclinic Vergelegen
Flood
November 2013

Index

Background
Event August 2013
Event November 2013
Study Lourens River
Damage
Difference – Flood level
Risk Mitigation
Lessons Learnt
Future

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Mediclinic Vergelegen
Background

1. Mediclinic Vergelegen is single story 199 bed multi disciplinary
   hospital, which includes a heart unit, large radiology practice, regional
   pathology unit and several doctors suites
2. The hospital is situated in the beautiful town of Somerset West in the
   Western Cape, within close proximity to the Lourens River
3. Since the late 90’s, several reports highlighted shortcomings with
   regards to the carry capacity of the Lourens River
4. Several proposals have been tabled. Due to cost constraints, only
   some of these recommendations were attended too
5. During 2013 the area was flooded twice
6. The first flood occurred in August, when 100 beds and four theatres
   were effected
7. On 15 November a low pressure system passed over the Western
   Cape region which caused substantial damage to property
8. The same day the hospital was completely flooded and evacuated

Helderberg Basin
Lourens River and History

                                                                                    4

Helderberg Basis constitutes
out off
1. Gordons Bay
2. Sir Lowry’s Pass Village                                                     3       2
3. Strand
4. Somerset West

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Medi-Clinic Corporation Limited | Presentation file name.ppt | 7-Sep-2010                   4

Event - August

Severity
• Partial flooding of hospital took place
• Water depth less than 100mm throughout
• Theatres 1, 2, 3 & 4, wards E, F, G and H had to be evacuated and was
  accommodated in hospital

Clean-up
• Started same evening and was completed within 5 days

Business Interruption
• Minimal Impact

Risk Mitigation
• Cleaned all storm water systems with high pressure
• Excavate emergency trench
• Appoint Civil Engineer 10 September 2013
• Report furnished on 11 November 2013

Event - August

Material Damage
• Mainly floor covering, doors and joinery kickboards

Event - November

Severity
• Extreme low pressure system over greater Western Cape Region
• Entire hospital was flooded
• Water depth more than 1 000 mm in certain areas
• On average between 400 mm to 700 mm throughout

Clean-up
• Started following day
• Focussed on doctors rooms and less impacted areas
• Reinstated rooms with emergency repairs within 5 days
• Reinstated 90 beds, 10 ICU beds, 4 theatres and EC within 10 days
• Rest of the hospital was completed within 72 days, 80 beds, cath lab, 11
  CC ICU, 7 CT ICU, 4 NICU, 3 theatres, radiology and pathology
• MRI was completed by March 2014

Event - November

Business Interruption
• Major impact on operation of greater medical village
• Hospital was evacuated and all services suspended

Risk Mitigation
• Cleaned all storm water systems with high pressure
• Built a temporary culvert/berm, December 2013
• Appointed land surveyor to measure surrounding contours
• Appoint civil engineer and designed retention system
• Obtain permission from council to build a retention dam on public space,
  have a public road reshaped and to discharge 12 m3/s hydraulic culvert
  water onto a public road
• Appointed contractor and work commenced during February after all
  approvals was obtained;
   • Project committee
   • Local authorities

Event - November

Material Damage
• Extensive damage to wall finishes, joinery, services and equipment
• Damage to ceilings – high level of moisture deformed boards
• Water ingress into walls, service ducts, conduit
• Discolouring of grout and water retention in walls, dry as well as
  masonry
• Many services are integrated into joinery, pedestals, head boards, etc.

Study Lourens River
Hydrology, Hydrodynamic modelling and Evaluation
of Mitigation measures

• The Institute for Water and Environmental Engineering,
  Department of Civil Engineering, of the University of
  Stellenbosch was appointed on 15 December 2013 to carry out
  an investigation on the flood hydrology and river hydraulics of
  the Lourens River.
• Final report was submitted on February 2014
• Slides 11 to 18 is abstracts from the above report

Study Lourens River

Study Lourens River

Medi-Clinic Corporation Limited | Presentation file name.ppt | 7-Sep-2010   12

Study Lourens River

Study Lourens River

Study Lourens River

Study Lourens River

Study Lourens River

    Neighbourhood below hospital

Study Lourens River

    Damming effect, walls, old bridge, railway, N2
    Lie within flood plane

Damage

Damage

Damage

Damage

Damage

Damage

         Damage to ceilings,
         tiles, joinery, services

Damage

Note:
Floor Services
Vacuum system
X-ray tube
Top heavy trolleys toppled

Difference – Flood Level

Difference – Flood Level

                           Nov

                           Aug

Risk Mitigation

Lessons Learned:
City of Cape Town

1.   Too many people responded
2.   Social Media – A new challenge
3.   Control Centre – SAP Somerset West, but that night present at hospital
4.   Doctors were not controlled by Control Centre
5.   Overall – Everything worked out very well

Lessons Learned:
Corporate Office

1.   Who takes control (Commander) if on site
2.   Media relations – Impact of social media and the control thereof
3.   Control Centre at hospital – Was flooded - Relocated
4.   Management – Commanders were not available at all times
5.   Traffic control – Was not done or possible
6.   Security – During and after disaster
7.   Board of Directors – Poor communication

Lessons Learned:
Corporate Office

8. Treating doctors were not called out soon enough to come and
    assist
9. Radiology / Pathology – To be integrated part of Hospital
    Emergency Plan
10. Receiving hospitals did not activate their external emergency
    plans
11. Nursing Care – Was sufficient care given to patients during
    evacuation?
12. Bed availability – How did we keep track of available beds at other
    facilities and the transfers – Centralized system

Lessons Learned:
Hospital
COMMUNICATION and INFORMATION!!!

1.   Cell phones do not work – Need radio’s
2.   Commanders to stay in Command Centre
3.   Command Centre requires regular updates
4.   Megaphone

Lessons Learned:
Hospital
1. Crowd control – Was impossible to manage - Lack of security (2 guards
   at night)
2. Command Centre flooded – Situated at EC, ground. Did not anticipate
   the severity of the situation
3. Asset control – No control on what was sent with patient to other
   hospitals
4. Loss of control over the transfer of patients due to multiple exits
5. Insurance of X-ray department: A potential risk to our business

Lessons Learned:
Hospital
1.   Enough staff to assist – Accessibility of hospital was a problem
2.   Clinical Care - Doctors were not called out soon enough
3.   Care to patients waiting to be transferred - Could we have done more?
4.   Accurate list of patients in hospital – Bed state vs AS400
5.   Number of ICU vs HC patients – Level of care needed
6.   Receiving hospitals did not activate their external emergency plans –
     Experienced their own disaster with number of patients being admitted

Lessons Learned:
Hospital
1. Not enough of the following equipment: Bibs and Torches
2. The lights stayed on – power reticulate from above with sufficient
   redundancy – Our saving grace
3. Escape routes – Were compromised lack of communication
4. Missing keys – A number of keys were missing or the location of key
   unknown
5. Storm water system inadequate – This will happen again if we do not
   put an alternative system in place

Lessons Learned:
Hospital

If you do not see or smell it, do not
assume it is dry – picture taken on
2014-03-28

Lessons Learned:
Greater Community
1. During the flood and evacuation how people pulled together in a calm
   and “organised” manner
2. People from various walks of life assisting without request
3. Contractors, suppliers, civilians arriving without request and offering
   help the morning after the flood
4. Past colleagues and colleagues from sister hospitals offering help and
   taking charge of specific areas
5. Contractors that seconded staff from other sites as far as
   Bloemfontein, that drove through the evening and started with the
   clean up process for days on end on arrival
6. Leave was cancelled and some even was called back from the camp
   site with their families so that deadlines could be met
7. Commitment from all working extremely long hours. It was noted as
   some where looking extremely sleep deprive while executing duties
8. Postponing of other contracts to pool resources
9. Suppliers pulling all stops, verifying all medical devices in a short
   period of time
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Lessons Learned:
Greater Community
10.Redirecting deliveries from other clients to replace written off
   equipment
11.What stood out:
   • Commitment from all
   • Unselfishness of offering time and working long hours
   • Positive spirit that prevailed after many days of working very close
      to 24/7 for an extended period of time
12.The ownership and willingness of all to get the facility up and running
13.A hospital is not a facility with equipment, but a central nerve centre for
   the greater community

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Future

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Future

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Medi-Clinic Corporation Limited | Presentation file name.ppt | 7-Sep-2010

Questions?
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