Flooding of Hospitals Due to Extreme Weather Conditions

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After a massive storm caused major flooding in the city of Malmö in Sweden, a method was developed to evaluate the resilience of the city’s hospitals to flooding and determine which hospitals were most vulnerable.

On the morning of August 31, 2014, the southwestern area of Sweden was hit by a massive storm and Malmö, one of the largest cities in Sweden, was severely struck by the storm which brought heavy rainfall and flash flooding. Roads were flooded, basements filled with water, and public transport was disrupted.

The Swedish Meteorological and Hydrological Institute (SMHI) had issued a ‘level 1’ warning, meaning that the weather could cause certain risks to the public and disruption for some civil functions. However, the hospital in Malmö was not prepared for the large amounts of surface water flooding due to the storm and consequences were severe at the hospital site. Surgical procedures were canceled, patients were evacuated, and equipment had to be replaced due to contamination.

As a consequence of the storm, Region Skåne, the healthcare organization responsible for the operation and maintenance of major hospitals in the area, contracted WSP (now part of WSP | Parsons Brinckerhoff) to investigate and evaluate the ability of hospitals in Skåne County to withstand future flooding events.

Defining the Method

Hospital disaster resilience can be defined as a hospital’s ability to respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one.

WSP | Parsons Brinckerhoff Fire & Risk group developed a method to evaluate the hospitals’ resilience related to flooding, determine which hospitals were most vulnerable, and suggest risk reducing actions to be implemented.

Nine hospitals in Skåne were visited and inspected, and maintenance personnel and other relevant staff were interviewed to acquire the necessary information.

Hospitals were evaluated to assess both the likelihood and the consequences of the flooding event. To determine the likelihood of flooding (high likelihood or low likelihood), key factors were analyzed such as:

  • past records of surface water penetrating the building;
  • building placement and orientation (e.g., on a slope, low ground, a hill); and
  • condition of the surrounding area (e.g., surface water, asphalt).

Depending on the answers, the investigated hospitals were put in either the “high likelihood” category or the “low likelihood” category.

To determine the consequences of a flooding event, a number of criteria were defined to determine the extent that medical care would be affected. These criteria included, amongst other effects, investigations regarding the type of equipment that would be affected if the hospital was flooded. Hospitals would then be placed in one of three categories of consequences – “small” consequences, “modest” consequences, and “large” consequences.

After determining the likelihood and consequences of a flood event, a schematic assessment of the overall risk value was performed.


resilience adaptive cycle processFigure 1 – Evaluation of Risk

After applying the method to the investigated hospitals (see Figure 1), the results were:

  • Four hospitals were categorized as “High risk”;
  • Two hospitals were categorized as “Medium risk”; and
  • Three hospitals were categorized as “Low risk”.


The method developed by WSP | Parsons Brinckerhoff to investigate and evaluate the ability of hospitals to withstand future flooding events provided the client, Region Skåne, with results that will enable them to prioritize future resilience work so that a focus can be on the hospitals in most need of risk-reducing measures.

The Swedish Meteorological and Hydrological Institute states that due to climate change, heavy rains will be more and more common in the future. This method can help counties, not only Skåne but also in other parts of Sweden, to evaluate current conditions and develop future resilience strategies.

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