My first thought after I saw Why Would You Build a Hospital in a Tsunami Zone was “who would knowingly build a critical facility in a inundation zone?” As I read more, my opinion changed. It makes sense for the community. I was, however, struck by the adversarial tone between the community and the state, and the lost opportunity to develop a “promising practice” for jurisdictions that face tough choices between current needs and looming, future disasters.
Emergency on the Horizon
January 26, 2015 is the 315th anniversary of the last Cascadia earthquake and tsunami. Geologists tell us we’re living on borrowed time until another major event occurs. What might this event look like? If this scenario developed by the Cascadia Region Earthquake Workgroup is any indication, it will be devastating:
It’s 8:16 on a chilly, wet morning in early spring. You’ve just arrived at work and are pouring a cup of coffee when you become aware of a low rumbling noise. Within seconds, the rumbling becomes a roar, the floor beneath you heaves, and the building begins to pitch and shake so violently that you’re thrown to the floor. The roaring is joined by a cacophony of crashing as windows shatter and every unsecured object in the room—from the desk chair to the coffee pot—is sent flying. Shaken loose by the shuddering and jolting of the building, dust and ceiling particles drift down like snow. Then the lights flicker and go out. Remembering to “drop, cover, and hold,” you crawl under the nearest table, hold on tight, and tell yourself that the shaking should last only a few seconds more . . . but it goes on and on.
If you live along the coastline, you have approximately 20-30 minutes to seek high ground. Scientists estimate that waves from a 9.0 subduction earthquake off the coast of Oregon could reach between 60 and 100 feet above sea level. Local topography will play a role in how much tidal surge an area receives. But if your community has seen tidal rises in previous tsunamis, you’ll certainly see this with a Cascadia event.
Based on the picture of impending catastrophic disaster, readers might suspect the state is correct in suggesting the hospital not build a hospital in the tsunami inundation zone. But I don’t think they are in this case. Let me explain.
Current Needs vs. Predicted Risk
The current hospital is in drastic need of repairs and updating. It’s so bad that the fire marshal gave them until mid-2016 to build a replacement building or face closing the doors due to safety concerns. In 2013, the community voted to support building a new one by passing a bond measure. Planning and designing is complete and the new facility is scheduled to open in 2016. Both the hospital and community seems to have done their due diligence in looking for alternative locations, but there don’t appear to be viable site solutions based on their needs and resources.
After the local work was done, the state entered the discussion and suggested the siting of the new hospital represents a failure. I disagree. It’s true that a Cascadia event will occur in the future and will represent a catastrophic disaster for the west coast of the United States and Canada, and that the new hospital will sit only 50 feet above sea level. It’s likely that one or multiple floors of the new facility will be flooded by a Cascadia event tsunami. However, it’s also true that community members seek and obtain their medical care from Curry General Hospital every day. To suggest the community is better without any hospital now because it may become uninhabitable in the future, makes no sense.
Assessing Daily Needs
Besides the daily impact a local hospital has on the health of community members, it is also a key economic and societal driver in the area. On average, the clinic and urgent care facility sees 2,000 patients per month. The new hospital will have 18 in-patient beds.
Did the state really weigh the impact to the health and safety of the whole community on a daily basis multiplied over the number of years until a possible Cascadia event occurs? Does the state really mean the site represents such an immediate danger to suggest it was wrong of the hospital to move ahead? Did the state step up with a solution other than “don’t build it there?”
There may have been discussions I’m not aware of, but this points out the need for inclusive planning to take place at a community level to let community stakeholders decide what’s best for them. 
Make Alternate Plans
I understand the new hospital may have up to 18 patients and maybe three times that number of staff at risk when the next Cascadia earthquake hits. They have designed the hospital so that inpatients and most staff would be on upper floors which may offer some protection against tsunami flooding. However, they could also develop and practice patient evacuation plans during times of low patient census — there will only be 20-30 minutes for the task. Training is key.
Gold Beach or Curry County could also explore a sister-county agreement with an Oregon county not expected to be impacted by a Cascadia event. That way someone will be prepared to come to their immediate assistance. This was a lesson learned by some prefectures in Japan after the 1995 Kobe earthquake and again after the 2011 Tohoku earthquake. Rather than wait for help to come, they had pre-planned where assistance would come from and what it would entail.
Select Disaster Staging Areas
The state should recognize the daily economic, societal, and medical benefits that will come from a new Curry County hospital. They should also recognize that Curry County may not have a hospital after a catastrophic event. So why not develop an interim solution to helping survivors?
I suspect that within Curry County there are state buildings or forest land which sits on higher ground that would not be prone to landslides. Why not help the county stockpile or pre-stage supplies within shipping containers to help survivors until more substantial help can arrive?
There are solutions to be found. We just need to open our eyes and look for them.
The whole topic of where to site something brought me back to one day at the mouth of the Columbia River. I had been doing ground validation work of our tsunami inundation maps with an Oregon geologist. We stood at the lookout tower at Fort Stevens State Park, taking in the view of the beach and Pacific Ocean in front of us, the community behind us. The geologist said “this will all be under water some day”. Then he went on to say, “I’d build a house right here today if I could, it’s beautiful.”
I’m curious to your opinions on the situation currently underway in Gold Beach, and what your recommendations would be.
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