The deadly earthquake that struck Italy this week shows how governments and individuals need to ramp up efforts to protect vulnerable populations and buildings from disasters, even in rich countries, experts say.

The powerful quake devastated medieval towns and villages in Italy's rugged central Abruzzo region, killing nearly 290 people and making 28,000 people homeless. Officials in the worst-hit town of L'Aquila estimated two-thirds of buildings had been ruined, including a public hospital and part of a university residence.

Margareta Wahlstrom, the U.N. Assistant Secretary-General for Disaster Risk Reduction, said Italy should now review the safety of buildings in quake-prone mountainous regions - a task for which it possesses the science, technology and money.

"I think one has to use these opportunities - when everybody is alert to it - to actually look at questions like do you have to move people out of the buildings and what are the alternatives, and to review hospitals, schools and public buildings," she told AlertNet.

Gian Michele Calvi, chairman of the European centre for research in earthquake engineering, has said that 80,000 public buildings in Italy are still unsafe despite the enforcement of construction regulations after previous natural disasters.

Experts say the historic nature of Italy's Romanesque and Renaissance churches and monuments complicates the challenge of making old towns like L'Aquila more resilient to earthquakes.

Tiziana Rossetto, an Italian earthquake engineering specialist at London's Aon Benfield UCL Hazard Research Centre, said the walls of ancient structures can be reinforced by linking them with steel cables but this kind of work tends to be costly.

Rossetto - who will lead a team to the disaster area to investigate why so many buildings fell down - said the quake should spur Italy to study the vulnerability of its historic towns so it can prioritise particularly risky areas.

But she emphasised that many of the buildings seriously damaged in the quake were modern - built after World War Two, although in some cases before anti-quake standards were first introduced in the 1970s.

Franco Barberi, who heads a committee assessing earthquake risks at Italy's Civil Protection agency, has hinted at poor control on construction quality, arguing that no one would have been killed had a similar quake occurred in California.

MAKING PUBLIC BUILDINGS SAFER

Experts are particularly concerned about the collapse of L'Aquila's public hospital, which was hailed as a state-of-the-art, earthquake-proof building when it opened in 2000.

"You might ask yourself the question, why hadn't it been retro-fitted or made to comply with current standards?" said Rossetto, adding that she understood some sections of the building were older.

According to the U.N. International Strategy for Disaster Reduction (ISDR), applying earthquake-resistant features during construction adds less than 5 percent to costs on average, whereas altering buildings after they have been completed can be three times more expensive.

Since October, the ISDR has been running a campaign, with the World Health Organisation and the World Bank, to raise awareness about how and why health facilities should be protected better from disasters.

The Italian quake underlines how much work remains to be done, said Wahlstrom, who is one of ISDR's top officials. "It's not ignorance but there's a real lack of momentum."

Robert Roots, a disaster preparedness adviser with the British Red Cross, recommended better planning to give emergency vehicles like ambulances access to narrow village streets that are easily blocked by rubble.

"Mountainous towns in Italy - these beautiful towns up in the hills that you go to and you think, wow - they are potentially death traps as well," he warned.

And he stressed that people must also be helped to help themselves. Measures promoted by the Red Cross include equipping individuals with skills like first aid and search and rescue, enabling them to respond quickly in a disaster.

Wahlstrom said it might also be possible to change the use of older buildings to lower the risk to those inside, but moving people away from seismically active regions on a long-term basis is only viable if governments can offer alternative accommodation and jobs.

But UCL's Rossetto said evacuating populations before an earthquake hits is not a realistic option, because even when there are a series of smaller tremors over weeks or months - as with this week's disaster - it is impossible to predict whether these will culminate in a major event.

CULTURAL RESISTANCE?

Beyond practical measures, Wahlstrom said now is the time for a major public campaign to inform Italians about the importance of taking action to prevent and prepare for disasters.

According to Britain's Daily Telegraph newspaper, the head of Italy's National Geophysics Institute, Enzo Boschi, believes his country's real problem lies with a failure to take preventive measures despite a history of tragic quakes.

The ISDR says around 25 major quakes have struck Italy in the past 40 years, killing more than 5,000 people and injuring tens of thousands more.

"We have earthquakes but then we forget and do nothing," the paper quoted Boschi as saying. "It's not in our culture to take precautions or build in an appropriate way in areas where there could be strong earthquakes."

But experts interviewed by AlertNet disagreed.

"It's hard to keep people aware of these events, but I don't think Italy is different from anybody else," said UCL's Rossetto. "I don't think there's anything in our culture which says we shouldn't prepare at all. Indeed, I'd say we are quite a cautious population."

Wahlstrom said the Italian government was actively engaged with international programmes to reduce disaster risk.

"In Italy - like in most countries in the world - it's not the laws that are remiss on this," she said. "The legislation exists, but the ability and pursuit of implementation is not always what it needs to be."

She agreed that European publics have tended to take a rather lackadaisical approach to the risk of disasters, but she expects that to change as climate change brings more hazards like floods, heat waves and avalanches.

Strong social protection networks - including insurance and swift government-backed reconstruction after disasters - have also helped reduce the urgency of the threat, Wahlstrom said.

"It probably doesn't impact us as individuals yet as much as it does in many other countries," she said. "But I would argue therefore that public education is even more important here, so that the decisions we take every day are better informed."

For example, members of the public could play a stronger role in pressing authorities to ensure that buildings like schools and hospitals comply with quake-resistant codes, she said.

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