中華民國內政部建築研究所中華民國內政部建築研究所

一、研究緣起
臺灣面臨著高自然災害脆弱度與社會災害脆弱度加劇的雙重挑戰，高齡者常因身體機能退化形成的脆弱，導致災害發生後避難更不易，由於震災後的避難收容時間較長，面對居住環境改變無法適應而導致快速衰弱而死亡。多數患有慢性病的高齡者，可能因為藥物中斷與身體機能需求無法滿足，增加發病率或死亡率的風險，災害罹難比例超過其他世代，在後續的避難、安置過程中常因健康惡化、邊緣化問題而發生「關聯死」、「孤獨死」的現象(蔡綽芳、蔡淑瑩等，2018)。
有鑑於現行防救災體系，已為長照體系下的相關機構(包含老人安養中心、護理之家)及醫療院所提供災時因應對策；故本研究擬針對平時生活在家中的居家被照護者為主要探討對象，但不包括安置在安養機構或醫院療養的人，以全齡之特殊需求者為研究對象，但因應高齡社會趨勢，對象多為高齡者。
參考過往實務經驗，短期收容時間以不超過2週為原則，因高齡者的身心理機能限制，避難過程中產生相較於一般避難者較多的特殊避難需求，但目前的災害防救體制，針對特殊避難需求者較缺乏細緻化的應變機制與作法；因此本研究延續內政部建築研究所(2020)計畫，強化特殊避難難機制可操作性，參考美國與日本針對特殊避難需求者之避難空間設計原則，探討我國災後作為避難收容處所的既有建物類型，並進一步評估特殊避難需求者之避難生活機能需求，提出因應災後特殊避難需求在空間與設施整備之建議，研擬空間設置參考手冊(草案)，以利後續公私機構設置特殊避難收容所時應用。
二、研究方法及過程
透過文獻回顧、現況調查及焦點團體等方式，參考國外對於福祉避難空間設計原則，並考量臺灣本土的條件，吸納公、私部門及專業人士的專業意見，以瞭解若臺灣建置特殊避難空間參考手冊所面臨之課題，使研究的操作過程思考更為客觀多元，提高研究成果之可應用性。
三、重要發現
(一)我國建置短期特殊避難收容機制
延續前一年度研究成果，研究者針對特殊避難需求者制定的避難機制，其內容主要著重在災時特殊避難需求者之分級制度、後送分流機制的界定；特殊避難需求者失能程度判斷，災時若原已有長照等級判定與證明的避難收容者，則以長照分類區分失能程度；避難收容現場若無相關證明可供判定，建議採用長照1.0失能程度(ADLs及IADLs)作為分級標準，而平時的對象掌握，則依照各地方政府長照主管單位之評估，進行造冊列管。
為避免浪費醫療資源及人力等因素，後送分流機制依據收容對象之失能程度(輕度、中度、重度)，對應至避難階段醫療照護嚴重程度，將空間類型分為一般避難所、特殊避難收容場所、住宿型長照機構(緊急收容)、醫療院所(入院治療)；根據近年各縣市避難收容處所一覽表，所訂定適用各種災害設置的避難處所，大部分是活動中心、學校、教堂、廟宇等場所(黃麗美、陳嘉基、曾俊達，2014)，因此本案僅針對「一般避難所兼用特殊避難收容場所」提出因應災後特殊避難需求空間與設施整備原則，一般避難所兼用特殊避難空間，應與一般避難收容空間分區，以提供安靜、基本生活機能、無障礙與兼顧照顧者與被照顧者的避難收容空間。
(二)高齡特殊避難空間設置課題對策
參考國外福祉避難空間設計原則，並考量臺灣本土的條件，瞭解我國若建置特殊避難空間，從災防體制執行、空間整備、物資與設施儲備及人口密度差異等層面，所面臨的課題如下：
現行的災防體制未要求避難空間應遵守的原則，導致平時的空間應用造成災時不利於避難收容使用；建物前期規劃設計階段未對防災基本設施做周全評估與設置，進而後續指定為避難所，其災時應變在空間轉換上不符合需求；現有作為避難收容空間，多分散在不同棟樓或樓層，空間轉換上常因設置門檻或障礙物，而導致空間難已到達；避難收容物資設施儲備，欠缺對高齡者與特殊避難需求者避難機能需求之細緻考量；人口密度低之地區資源整備與發展，因佔地廣闊空間分散，相較於人口稠密區較不完善，災時容易因交通阻斷而成孤島，導致救援不易，物資設備無法及時調度。
解決對策應落實建置特殊避難場所的可行性，訂定特殊避難收容空間整備與開設運作參考原則，依據臺灣現行建築法規，制定相關分區合適之基本空間尺寸規範，並透過檢核評估表，依評估缺失項目改善特殊避難需求者避難生活環境，提升生活機能；特殊避難需求者平時物資儲備建議，建議從七大面向(食、衣、住、行、衛生、醫療、社交)探討應具備之物資，考量地區特性越偏遠的地區，交通可及性影響因素越大(如道路容易中斷等問題)，需要預估的儲存天數就越長，因此將儲備容量分為：山區、易成孤島地區(儲備至少14天)，農村、偏遠地區(儲備至少3天)，都會、半都會地區(儲備至少2天)。
(三)研擬高齡特殊避難空間操作手冊
手冊之使用對象，為建置特殊避難空間時以簡易閱讀的方式，在平時物資準備、空間整備及災害應變時成為參考指標，以便利地方執行單位，能依循此依據操作；參考我國災害防救計畫作為特殊避難空間參考手冊的架構研擬，手冊內共分為四大部分，主要針對平時物資儲備、收容對象評估、避難所開設機制流程、空間整備原則及其他交通協助、人力支援、傳染病防治提出原則。
選擇特殊避難場所的基本原則，應先充分瞭解建物之現況、震災經驗、歷次毀損與修復補強情形等，確保建物設施本身之安全性、無障礙性及符合特殊避難之需求；依循既有規範「建築技術規則」及「無障礙設計規範」配置特殊避難場所分區，分為作業區域、服務區域、主要收容區域，並考量特殊避難需求者的身心障礙特徵，列舉優先設置空間；以大震災為前提下，人口密度多寡會影響特殊避難場所的開設規模與時機。收容時間長短，會影響特殊避難場所的空間配置急迫性，及特殊避難物資優先提供之必要性；特殊避難場所的開設規模，收容人數參考長期照顧設立標準，以10名需設置1位照顧服務員為基準，開設時間3日以維持生命基本需求為主，14日為滿足日常生活需求為主。
四、主要建議事項
建議一
制定特殊避難空間之設置條件指引：立即可行建議
主辦單位：內政部建築研究所
協辦單位：災害防救辦公室
依據避難收容處所的空間種類整理，主要避難收容場所多以公園(係以較大型的防災公園為主)、里(區)民活動中心、學校為主，針對不同空間類型之一般避難收容場所，被指定為避難收場所時，制定可作為特殊避難收容用途之空間條件指引，如須具有停車空間、基礎無障礙設施等，並延續避難收容空間操作手冊原則，分別提出應注意事項，避免造成避難空間特殊性消失。
建議二
建置特殊避難空間配置模組型式：立即可行建議
主辦單位：內政部建築研究所
協辦單位：各縣市政府教育局、社會局
收容空間類型可區分為二大類型，其一為獨立整體性空間，如體育館、室內球場、里(區)民活動中心，其二為單一群體性空間，如教室、圖書室、會議室等；後續應從空間的整體性，探討現有避難收容場所，建置特殊避難空間模組的合宜性。
建議三
提出避難收容場所硬體設施之整備項目檢核表：中長期建議
主辦單位：各縣市政府教育局、社會局
協辦單位：各縣市政府工務局
參考日本校園防災設施整備對策，提出避難收容場所硬體設施之整備項目檢核表，可作為未來建物改建或新建時，在前期規劃階段，對於硬體設施，如耐震性儲水槽、排水管道、機電管路建置，即納入防災需求評估，以便後續若被指定為避難場所時可作為參考依據。
建議四
建構特殊避難場所開設收容規模：中長期建議
主辦單位：內政部建築研究所
協辦單位：內政部災害防救辦公室、衛生福利部
蒐集國內居家照護對象、高齡化指標及其他相關數據，並應用至災害防救機制上，作為開設及收容人數規模的推估，提出不同的作業模式，以完善特殊避難收制度的建置。
建議五
建置特殊避難災害應變權責分工建議：中長期建議
主辦單位：內政部災害防救辦公室
協辦單位：地方政府特殊避難權責相關單位
針對現有災害防救體制權責單位，由上至下層級進行權責分配檢討，藉由跨部會協調會議，討論工作內容認定方式，以落實地方政府執行時的分工依據。

I.Origin
Taiwan is faced with a high frequency of natural disasters and challenges brought about by an aging society. Due to low physical and mental functions, the elderly are more prone to disaster-related injuries. During a long period of shelter after an earthquake, the elderly become debilitated quickly and eventually die due to difficulty in adapting to a new environment. Most elderly people with chronic diseases may be at risk of morbidity or mortality due to drug interruption and physical deterioration; therefore, the elderly suffer from more disaster-related deaths than other generations. During the process of evacuation and resettlement, “related deaths” and “lonely deaths” may occur as a result of health deterioration and marginalization (Cai, Chuo-Fang & Tsai, Shu-Ying, 2018).
Relevant response measures are already put in place for long-term care facilities and medical institutions (e.g., nursing homes and care homes for the elderly) under the existing disaster prevention and relief system. The main subjects of this study are home care recipients, along with people of all ages with special needs, most of whom are the elderly in this aging society, not including those living in nursing homes or hospitals.
Based on past experience, the period of short-term shelter is no more than two weeks in principle. Compared with ordinary people, the elderly have more special requirements due to their physical and mental limitations during the evacuation. At present, the disaster prevention and relief system are yet to set detailed response measures and practices for people with special shelter needs. In view of this, this study, following the program of the Architecture and Building Research Institute, Ministry of the Interior (2020), aims to improve the operability of special shelter mechanisms. Referring to the principles of shelter space design for people with special shelter needs in the United States and Japan, this study explores the types of existing buildings that serve as shelters in Taiwan after the occurrence of an earthquake and further evaluates the daily supplies required by people with special shelter needs to sustain themselves; then, it puts forward recommendations for space and facilities in response to special shelter needs after the occurrence of an earthquake and drafts a handbook of special shelter design for public and private sectors’ reference.
II.Research Methodology and Process
Through literature review, field investigation, and focus group discussions and based on the principles of shelter space design in other countries, Taiwan’s local conditions, and opinions from the public and private sectors and professionals, this study seeks to find out the issues arising from the formulation of the handbook of special shelter design in order to make the findings of the study more applicable from objective and diverse perspectives.
III.Findings
(1)Short-term special refuge and shelter mechanisms in Taiwan
Following the findings of the previous year’s study, shelter mechanisms for people with special shelter needs are defined based on the classification of people with special shelter needs upon the occurrence of an earthquake. Those with disabilities are classified based on the long-term care system if having been determined and manifested thereof upon the occurrence of an earthquake; for those without relevant proof presented at the shelter, classifying them with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) under the Long-term Care Plan 1.0 is recommended. In peacetime, people with special shelter needs are listed for control by local authorities in charge of long-term care.
To avoid wasting medical resources and manpower, people with shelter needs are sent to general refuges, special refuges, and shelters, residential long-term care facilities (emergency shelters), or medical institutions (hospitalization) based on their disabilities (mild, moderate, and severe) and needs for medical care during the evacuation. According to the list of shelters in cities and counties in recent years, most of the shelters suitable for various disasters are activity centers, schools, churches, temples, and other places (Huang, Li-Mei, Chen, Chia-Chi, and Tseng, Chun-Ta, 2014). In this study, the design of shelter space and facilities in response to earthquake disasters is proposed only for “general refuges and special refuges and shelters.” General refuges and special refuges and shelters should be partitioned from general refuges to provide quiet and barrier-free space for both caregivers and care recipients to sustain themselves.
(2)Issues and countermeasures in relation to the establishment of special shelter space for the elderly
Based on the principles of shelter space design in other countries and Taiwan’s local conditions, this study seeks to find out the following issues arising from the establishment of special shelter space in aspects of disaster prevention system, preparation for space, the reserve of supplies, and facilities, and difference in population density:
When disasters occur, the use of space in peacetime is not adequate for shelter during the evaluation as there are no rules of shelter space to be abided by under the existing disaster prevention system. Disaster prevention facilities are not fully assessed and installed in the early planning and design of buildings and then designated as refuges for future use, making these buildings unfit to respond to disasters in terms of space conversion. Existing refuges and shelters are mostly located on different buildings or floors, making them less accessible due to settings such as thresholds and obstacles. Thorough consideration is not given to the reserve of supplies and facilities in refuges and shelters for the elderly and people with special shelter needs. Compared with densely populated areas, areas with low population density are less complete in preparation for resources due to the vast and scattered territory. When earthquakes occur, they become isolated easily due to traffic interruption, which makes it difficult to rescue people and send supplies and facilities in a timely manner.
To determine whether it is feasible to establish special refuges and shelters, the guidelines for preparing and establishing special refuges and shelters should be formulated. An appropriate scale of shelter space should be defined according to the existing building laws and regulations in Taiwan; a checklist should also be created to identify what people with special shelter needs lack, so as to improve their living environment. The daily supplies of people with special shelter needs should be considered in seven aspects (i.e., food, clothing, accommodation, transportation, hygiene, healthcare, and social contact). Given the characteristics of a remote area where traffic accessibility (e.g., road interruption) plays a critical role, the estimated days of the reserve are longer; therefore, areas by reserve are divided into mountainous areas and areas prone to isolation (at least 14 days), rural areas and remote areas (at least 3 days), and metropolitan areas and semi-metropolitan areas (at least 2 days).
(3)Formulation of the handbook of special shelter design
The handbook should be easy-to-read for users when establishing special shelters and serve as a reference for local authorities when preparing for supplies and facilities and responding to disasters. Formulated based on the national disaster prevention and relief plan, the handbook consists of four parts and sets the guidelines for the reserve of supplies, evaluation of people to be sheltered, mechanisms and procedures for establishing shelters, preparation for space, traffic and manpower support, and prevention of infectious diseases.
When choosing a special shelter, one should first learn about the status, earthquake experience, and damage, and repair and reinforcement of the building to ensure that the building is safe, barrier-free, and compliant with the special shelter needs. According to the “Building Technical Regulations” and the “Barrier-free Design Regulations,” special shelters should be partitioned into the work area, service area, and shelter area and prioritize space based on the disabilities of people with special shelter needs. Given a major earthquake disaster, the population density will affect the scale and timing of the establishment of special shelters. The period of shelter will affect the urgency of spatial configuration and the necessity of giving priority to supplies in special refuges. Based on the standards for long-term care facilities, one caregiver should be appointed to ten people received in a special shelter; a special shelter is established for 3 days to maintain basic needs and for 14 days to meet the daily needs of people.
IV.Recommendations
Recommendation 1
Formulating the guidelines for establishing special shelter space: immediate and feasible 
Organizer: Architecture and Building Research Institute, Ministry of the Interior
Co-organizer: Office of Disaster Management, Ministry of the Interior
By space types, refuges and shelters are mostly parks (large disaster prevention parks), community (activity) centers, and schools. When general refuges of different types of space are designated as special refuges and shelters, the guidelines for spatial conditions (e.g., parking space and barrier-free facilities) should be formulated; matters needing attention should also be put forward according to the handbook of special shelter design to keep the particularity of the refuges and shelters.
Recommendation 2
Creating the models of special shelter space: immediate and feasible
Organizer: Architecture and Building Research Institute, Ministry of the Interior
Co-organizer: education department and social welfare department at city/county level
Shelter space is classified into two types. One is independent holistic space such as gyms, indoor courts, and community (activity) centers and the other is single group space such as classrooms, libraries, and meeting rooms. The suitability of creating the models of special shelter space should be subsequently discussed based on the entirety of shelter space.
Recommendation 3
Providing a checklist of shelter facilities: medium and long-term
Organizer: education department and social welfare department at city/county level
Co-organizer: public works department at city/county level
A checklist of shelter facilities should be provided based on Japanese schools’ strategies for disaster prevention facilities for authorities to refer to when evaluating the earthquake-resistant requirements for the facilities of buildings (e.g., earthquake-resistant storage tanks, drainage pipes, and electromechanical pipelines) during the preliminary planning of construction or reconstruction and later designating the buildings as shelters.
Recommendation 4
Determining the scale of special shelter: medium and long-term
Organizer: Architecture and Building Research Institute, Ministry of the Interior
Co-organizer: Office of Disaster Management, Ministry of the Interior, and Ministry of Health and Welfare
Data in relation to home care recipients and aging indicators in Taiwan should be collected and used in the disaster prevention and relief system to estimate the number and capacity of special shelters and propose different operating models accordingly, so as to create a perfect special refuge and shelter system.
Recommendation 5
Defining the division of powers and responsibilities for disaster-related special shelter: medium and long-term
Organizer: Office of Disaster Management, Ministry of the Interior
Co-organizer: Local Authorities of The Special Shelter Related Powers and Responsibilities
Under the existing disaster prevention and relief system, the powers and responsibilities of authorities should be assigned and reviewed from top to bottom; the course of tasks assigned to and completed by each authority should be discussed through inter-ministerial coordination meetings to implement the division of work of the local governments.