## 5 Conclusions  
The performance of the reinforced concrete hospital building was evaluated, and several deficiencies were expected given that the structure was constructed without strict adherence to the seismic codes, and the following conclusions can be deduced.  
1. The performance of the structure when exposed to Push Y earthquake forces is much better than in the X direction; the maximum roof displacement in this direction is significantly reduced as compared to that in the X direction. This is mostly due to the presence of four shear walls in the direction of the expected in-plane forces, which can undertake the majority of the shear forces as compared to those that take the forces from the X direction. The strong column-weak beam principle comes to mind at this stage. To mitigate this, additional shear walls in the X direction can be installed; this would balance the in-plane forces, improving the structure's overall resilience.
2. It is also observed that hinges start forming at the columns, though this should ordinarily start at the beams; these are more significant due to the fear of global progressive collapse, which can be brought about by the failure of columns, as opposed to local collapse, which is common with hinges in beams. This can be addressed by redesigning or retrofitting the structure to shift hinge formations to the beams, adhering to the principles of ductile detailing.
3. The design lateral loads are much greater than those allowed for the required limit state at the no damage to damage limit state for a hospital. This means that in case of an earthquake action occurring, then there is high potential for the structure to fail.  
This calls for the concerned parties to take all the necessary measures to minimize the vulnerability of the structure. This necessitates the strengthening of the structure to handle the expected lateral loads effectively.
4. The structure, with additional shear walls in the Y direction, is structurally non-ductile due to poor seismic rules. This makes it more vulnerable to failure during seismic events, especially in the X direction. This raises concerns about the building's ability to deliver essential services during seismic occurrences, especially for hospitals.
5. The evaluation emphasizes the need for retrofitting vulnerable structural elements, particularly columns, to improve seismic performance and reduce collapse risk in non-ductile reinforced concrete frame buildings. However, variability in performance requires careful design and execution considering specific building vulnerabilities. For example, the hospital's retrofitting measures should focus on improving seismic performance in the X direction, where it currently has significant weaknesses.
6. From observation, it is evident that the shear walls are improperly located in the structure, leading to torsional irregularity in the building, which contributes to the vulnerabilities observed in the building. This can lead to uneven distribution of forces in the event of an earthquake. Therefore, addressing this issue via the correct placement of shear walls can aid in mitigating seismic risks and enhancing the structure's resilience.
7. While pushover analysis offers valuable insights into the seismic behavior of structures, the importance of shear considerations cannot be overstated. Our analysis highlighted potential shear vulnerabilities that warrant further attention and possible retrofitting measures. For future seismic assessments, especially for vital infrastructures, a holistic approach encompassing both flexural and shear behaviors is recommended.  
Conceptualization, K.K.K. and O.K.K.-B.; investigations. K.K.K.; writing-original draft preparation, K.K.K.; writing-review and editing, O.K.K.-B.; supervision, O.K.K.-B. All authors have read and agreed to the published version of the manuscript.  
This research received no external funding.  
Not applicable.  
All data presented in the study are available in the article.  
The authors declare no conflict of interest.