Hospital Resilience in a Multi-Hazard Era: Water Security Planning in Northern Thailand
Abstract
1. Introduction
1.1. Global Context
1.2. Thailand Context
1.3. Objectives
- What are the typical patterns of water use in hospitals across northern Thailand, and how do they compare with international benchmarks?
- To what extent did hospitals experience water shortages during the 2019–2020 compound drought–pandemic period?
- What preparedness and adaptation strategies are needed to improve hospital water security and resilience?
2. Background
2.1. Water Availability
2.2. Drought and Flood Risk
2.3. Water Supply Management in Thailand
2.4. Overview of the Thai Hospital System
3. Materials and Methods
3.1. Data Collection
3.2. Response
4. Findings
4.1. Hospitals Reporting COVID-19 Activity
4.2. Water Use Patterns
4.3. Water Sufficiency, Quality, and Planning
5. Discussion
5.1. Efficiency, Strategic Planning, and Risk Reduction
5.2. Hazard Management Team Model
5.3. Sustainability Issues
5.4. Limitations
6. Conclusions
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Information Sought from Hospital Administrators for the Study
- Timestamp
- Name of your hospital
- Province in which your hospital is located
- What is the level/type of your hospital?
- How many patient beds does your hospital have?
- Has your hospital been designated to screen or admit COVID-19 patients?
- How sufficient is your hospital’s water supply?
- What is your hospital’s primary water source?
- Does your hospital have sufficient water quantity and quality for its needs?
- Does your hospital use any water recycling or reuse techniques to augment supply?
- Has drought affected water sufficiency at your hospital?
- Has the COVID-19 situation further affected your hospital’s water sufficiency?
- Does your hospital have a water management plan (describe)?
- Does your hospital have a water management plan specifically for crisis or disaster scenarios?
- During the drought and COVID-19 situation, has your hospital implemented additional water management measures beyond normal operations (describe)?
- Are there any government measures or policies supporting your hospital’s water use?
- What is your hospital’s average monthly water consumption (in volume)?
- What is your hospital’s average water use per patient?
Appendix B. Additional Information That Could Be Collected to Study Water Consumption
- 19.
- Types of services offered (e.g., emergency, surgery, long-term care, maternity, dialysis, intensive care).
- 20.
- Total number of beds and average occupancy rate (%).
- 21.
- Total number of staff (clinical, administrative, cleaning, etc.).
- 22.
- Total built area (m2) and site area (outdoor grounds if irrigated).
- 23.
- Main water supply source(s) (municipal well, surface water, rainwater, etc.).
- 24.
- Drinking water source and treatment method (e.g., RO, UV, bottled).
- 25.
- Use of filtered vs. unfiltered water (with specification of treatment technologies).
- 26.
- Monthly water usage disaggregated by season or key operational periods.
- 27.
- Average daily water use per patient (per inpatients, outpatients, ICU patients).
- 28.
- Water use breakdown by sector (e.g., kitchen, laundry, HVAC, sterilization, patient care, sanitation).
- 29.
- Greywater recovery or recycling (volume, use areas, treatment method).
- 30.
- Presence of water-efficient fixtures/retrofits (e.g., low-flow taps, sensor-based flush).
- 31.
- Water loss monitoring and control (e.g., leaks, overflow prevention systems).
- 32.
- Type of wastewater treatment (onsite, municipal, septic, advanced treatment).
- 33.
- Separation or special handling for high-risk wastewater (e.g., infectious disease wards, labs, radioactive waste).
- 34.
- Wastewater reuse (if any) and discharge standards compliance.
- 35.
- Water budget (annual cost, allocation by sector if available).
- 36.
- Emergency and drought contingency measures (e.g., water trucks, prioritized services, emergency tanks).
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Median | Min | Max | IQR | |
---|---|---|---|---|
All Hospitals (67) | 460 | 69 | 14,959 | 306–777 |
Community Hospitals (58) | 414 | 69 | 2992 | 269–621 |
General Hospitals (4) | 2301 | 921 | 3797 | 1093–3538 |
Specialty Hospitals (5) | 1202 | 312 | 14,959 | 513–5341 |
Median | Min | Max | IQR | |
---|---|---|---|---|
All Hospitals (67) | 9.2 | 2.6 | 28.8 | 6.9–12.1 |
Community Hospitals (58) | 9.2 | 3.5 | 28.8 | 6.9–12.4 |
General Hospitals (4) | 7.3 | 2.6 | 9.6 | 5.8–8.1 |
Specialty Hospitals (5) | 10.6 | 5.3 | 20.8 | 9.2–15.2 |
Country | Hospital Count | Bed ** Number | Water Use ** (m3/Bed/Week) | Study Focus | Hospital Type |
---|---|---|---|---|---|
Thailand * | 67 | 34 (10–1400) | 9.6 (2.6–28.8) | Total water usage | Various |
Germany [37] | 19 | 396 (45–1003) | 2.7 (2.2–4.3) | Water consumption | Various |
Germany [38] | 64 | NA | 2.8 (1.0–4.8) | Water consumption | Unknown |
Germany [39] | 1 | 1709 | 5.7 | Water consumption | University |
India [40] | 1 | 183 | 7.8 | Filtered water use | Cancer |
Italy [41] | 36 | 383 | 8.8 | Water use | Public |
Mauritius [42] | 1 | 435 | 4.5 | Water audit | Unknown |
Portugal [43] | 1 | 776 | 8.3 | Water consumption | Regional |
Spain [44] | 20 | 39 (193–1075) | 4.1. (1.2–7.6) | Water consumption | Mixed |
Spain [45] | 13 | ~30–500 | 5.0 | Water consumption | Unknown |
Spain [46] | 14 | 20–194 | 2.2 | Water consumption | Private |
Turkey [47] | 13 | 169 (5–810) | 3.7 | Total water usage | Public |
n | Planned Action |
---|---|
20 | Build a water reserve system (tanks or reservoir) * |
15 | Drill a well |
5 | Connect to Provincial Water Authority system |
3 | Request a water vehicle from the municipality |
2 | Connect with municipal water supply system |
2 | Request raw water from the municipality (e.g., via tank truck) |
1 | Drill a well and connect with the Provincial Water Authority system |
1 | Drill a well and request a water truck from the municipality |
1 | Build a water reserve system and request a water truck from the municipality * |
1 | Build a rainwater collection system |
A. Governance and Planning |
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B. Infrastructure and Systems |
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C. Data and Monitoring |
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D. Operational Preparedness |
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Ziegler, A.D.; Wangsan, K.; Supinit, P.; Potapohn, M. Hospital Resilience in a Multi-Hazard Era: Water Security Planning in Northern Thailand. Urban Sci. 2025, 9, 240. https://doi.org/10.3390/urbansci9070240
Ziegler AD, Wangsan K, Supinit P, Potapohn M. Hospital Resilience in a Multi-Hazard Era: Water Security Planning in Northern Thailand. Urban Science. 2025; 9(7):240. https://doi.org/10.3390/urbansci9070240
Chicago/Turabian StyleZiegler, Alan D., Kampanat Wangsan, Phadungpon Supinit, and Manoj Potapohn. 2025. "Hospital Resilience in a Multi-Hazard Era: Water Security Planning in Northern Thailand" Urban Science 9, no. 7: 240. https://doi.org/10.3390/urbansci9070240
APA StyleZiegler, A. D., Wangsan, K., Supinit, P., & Potapohn, M. (2025). Hospital Resilience in a Multi-Hazard Era: Water Security Planning in Northern Thailand. Urban Science, 9(7), 240. https://doi.org/10.3390/urbansci9070240