Often in disasters caused by earthquakes or floods, the spotlight falls on how many homes have been damaged or destroyed. But we tend to hear less about what happens to hospitals and clinics - just at the time when they're needed more than ever.

When I went to Pakistan in October 2006, a year after a major earthquake devastated large parts of the north, I visited a clinic run by the British medical relief charity Merlin, in a remote village in Kashmir's Neelum Valley.

While the villagers were getting a better level of care than before the disaster - they had a midwife for the first time - the consultations were taking place in tents because the clinic had collapsed in the quake. Half of it had been reduced to rubble, and no one seemed to know when it would be rebuilt.

What's a little surprising, as my colleague Thin Lei Win reports in this article on the recovery, is that the government has reconstructed less than 10 percent of healthcare facilities and schools - a full three years after the quake.

The focus of this year's United Nations International Day for Disaster Reduction - which coincides with the anniversary of the South Asia Earthquake - is on hospital safety.

In a press release it points out that 73 percent of health facilities were destroyed by the quake in the affected areas of Pakistan, making them unable to function when hundreds of thousands most needed medical care.

When Cyclone Nargis barrelled into Myanmar this May, 57 percent of health facilities in the regions it hit were damaged and one in five were completely destroyed, according to the United Nations. And it will cost the country a cool $12 million just to rebuild them, it says.

During China's Wenchuan earthquake, which also struck in May, 11,028 medical institutions were damaged, with 169 hospitals needing complete reconstruction.

In the light of these statistics, it's not surprising that the United Nations disaster reduction secretariat (UNISDR) and the World Health Organisation (WHO) are urging governments to invest more in hospital safety.

"We must build health centres and systems to withstand natural hazards and major emergencies," said WHO Director-General Margaret Chan in the statement. "If we don't, lives will be lost needlessly - both when hazards strike and in their aftermath."

Salvano Briceno, UNISDR director, said: "The immediate cost of disaster damage to health systems can deal serious blows to national budgets - but only a 4 percent initial investment in disaster protection can make most health facilities safe."

A high-level panel discussion calling for more action, "Saving Lives: Hospitals and Schools Safe from Disasters", is being held on Wednesday in New York, organised by UNISDR and supported by WHO and the World Bank.

And the World Disaster Reduction Campaign for 2008 and 2009 entitled "Hospitals Safe from Disasters" has launched a website at www.safehospitals.info, providing more information on the campaign and how to contribute.

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