MELISSA BLOCK, HOST:
For people throughout the Midwest, spring means the start of tornado season. When natural disasters strike, like tornadoes or hurricanes, hospitals have to be able to survive. From member station KCUR in Kansas City, Alex Smith reports on how hospitals are trying to strengthen their defenses against disaster.
ALEX SMITH: Shortly after one of the worst of tornadoes in U.S. history, Joplin, Mo., resident Brandon McCoy described what he saw during the storm.
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BRANDON COY: Standing on the sixth floor, I was trying to help a lady out of some debris. And you look outside and just - everything's gone - everything. And, you know, nobody knew what happened.
SMITH: One-hundred-fifty-eight people died as a result of the massive tornado in May 2011, and the property damage was catastrophic, particularly for St. John's Medical Center.
NORMAN MORGAN: What you're looking at is basically a brick building that's halfway out of the grade right now.
SMITH: Nearly four years later, Norman Morgan of the Dallas-based HKS architecture firm shows off the distinct features of Joplin's new hospital. It's covered in concrete and brick paneling, and many of the windows are built to hold up in 250-mile-per-hour winds. Outside you can see the roof of an underground bunker where the generators and boilers are housed out of the reach of danger.
ROBIN GUENTHER: To also provide essential community services as the most resistant or significant buildings in communities.
SMITH: Robin Guenther is a principal with Perkins and Will architecture firm. She co-authored a recent report for the Department of Health and Human Services describing how hospitals can better withstand natural disasters. She says that in many cases hospitals may need to be rebuilt from scratch, particularly on the coasts where flooding is a risk.
GUENTHER: Those hospitals actually need to be built upside down, meaning all of their key equipment should not be in the basements or undergrounds. It needs to actually be on the roof.
SMITH: The full-on storm hardening done at Joplin added up to about two-and-a-half percent of the total construction cost, or about $12 million. But Guenther says in less storm-prone areas, the job can be done for 1 percent or less. Despite that relatively low cost, prevention is a tough sell.
GUENTHER: We increase the level of strength of a building, wall or roof based on a disaster that causes damage, not before it happens.
RON MARSHALL: Having grown up in Kansas and being a native of Kansas, I think we've all learned to respect the power of tornadoes. And I don't think there's any skepticism that it couldn't happen to any of us.
SMITH: Ron Marshall coordinates hospital preparedness for the Kansas Hospital Association. Here at St. Francis Hospital in Topeka, he says they're focused on improving preparation strategies.
MARSHALL: We'd all love to go out and build a new tornado-safe hospital, but in today's reality of economics and health care, that's unfortunately not easily an option.
SMITH: More pressure for storm-proofing could be coming. Hurricanes Katrina, Sandy and Ike lead to some of the biggest insurance payouts in U.S. history. And worries about future losses may lead insurers to insist on new building requirements. For NPR News, I'm Alex Smith in Kansas City.
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