VEHA
Guidance
Guidance
Virtual Environmental and Humanitarian Adviser Tool – (VEHA Tool) is a tool
to easily integrate environmental considerations in humanitarian response. Field Implementation guidances are useful for the design and execution of humanitarian activities in the field.
People, flora, and fauna are vulnerable to contamination and disease, including from health waste. The disease may spread amongst and between species.
Community engagement remains a key component of outbreak response in order to prevent the spread of disease. Existing community perceptions and beliefs can support or hinder a response, so it is important to understand and address them. Some social norms may need to be modified to prevent disease transmission.
Children and the elderly and people with chronic or terminal health conditions are particularly affected by contaminated water as they have weaker immune systems.
Women are most likely to manage solid, water, and household waste, which can pose serious health risks if mismanaged. Contaminated water can also drain into streams and other surface water, which is used for washing, cleaning, and bathing increasing the risk of further contamination among women and children.
Air pollution
Coastal erosion
Deforestation
Desertification
Eutrophication
Natural resource depletion
Saltwater intrusion
Soil pollution
Water pollution
Water depletion
Loss of biodiversity and ecosystems
Unmanaged solid waste can have significant health and environmental impacts. Solid waste is often host to harmful pathogens and is also a breeding ground for insects and rodents, carriers of disease. Bio-hazardous waste, including contaminated tissues and expired or contaminated medicines and vitamins, can also lead to unintentional disease transmission if disposed of improperly. Unmanaged solid waste/wastewater/sewerage and fecal sludge can contaminate soils, surface waters, and groundwater.
Communicable disease spread has been exacerbated by factors such as climate change, environmental degradation, rapid urbanisation and industrialisation, and by the overlaps between disasters, conflict, and fragile situations. For example, climate change can increase temperature and weather extremes which can affect disease spread. Similarly, deforestation, livestock and agriculture activities, population density, urbanisation, wet markets, can all directly affect the spread of disease. Displacement and concentrations of people in camps with shared hygiene facilities can also spread disease.
If there are no preventive measures in place, humanitarian health response has to be deployed much faster and on a bigger scale. This utilises more, resources people, and transport costs more, places a greater burden on the health system and on the environment, and is usually less well organized, which in turn leads to increases the likelihood of increased environmental pollution and degradation.
Procurement and distribution of health items and services can be directly affected by the environment. For example, environmental hazards can impact the transport of essential medicines (e.g.: if roads are flooded medicines cannot be transported by vehicle). Transportation activities usually depend on fossil fuels that contribute to climate change and reduce local air quality.
Develop and disseminate an integrated outbreak preparedness and response plan, including:
‘Review community structures, behaviours, livelihoods, and existing diseases and disease spread to assess the risk of spread of communicable diseases in the affected population.
Conduct a healthcare waste assessment to determine current wastes produced, waste volumes, waste handling, separation, processing, and disposal. Identify hazards or poor practice and plan to remedy. Develop on-site facilities for safe decontamination, destruction, or containment of hazardous health waste. Identify appropriate authorized companies and pay them to adequately dispose of healthcare waste. Where new or separate facilities are established or existing facilities expanded, develop a decommissioning plan and plans for providing water, wastewater, and waste and biohazard waste disposal. Also, consider cooking and personal hygiene requirements.
Preparedness allows for an early and efficient response and therefore helps to save lives, reduce suffering and pre-empt or decrease the extent of needs. In this way, it lessens the impact of a hazard and/or threat and contributes to resilience. Develop and disseminate an integrated outbreak preparedness and response plan. This should assess existing local and proximate known diseases and map potential disease spread routes such as through human contact and population density, cultural customs such as cooking, eating, hand washing, hygiene, and burial practices. Integrated outbreak preparedness plans should always consider the environment. The main objective of the plan is to protect lives and the environment by reducing the incidence, transmission, and severity of disease and the potential impacts on people. Ensure the plan develops potential transmission and infection scenarios. Plan accordingly to scenarios identified in relation to your organisation capacities, sharing information, and collaborating with other health actors. Ensure coordination with partners to cover gaps and needs.
Assess and remedy sources of disease transmission, including soil and water contamination due to poor wastewater, excreta, and solid waste management from communities and from health facilities. Assess the current and projected impacts of climate change such as increased temperature and weather extremes which will increase disease vectors and disease transmission in many locations. Assess and address transmission through livelihoods activities including deforestation, livestock and agriculture, food processing, and wet markets. Similarly assess impacts of increased population density, urbanisation and displacement, and concentrations of people in camps with shared hygiene facilities.
Bodies should not be buried in “Body Bags” as these will limit natural decomposition.
Develop and disseminate an integrated outbreak preparedness and response plan. This should assess existing local and proximate known diseases and map potential disease spread routes such as through human contact and population density, cultural customs such as cooking, eating, hand washing, hygiene, and burial practices. Integrated outbreak preparedness plans should always consider the environment. The main objective of the plan is to protect lives and the environment by reducing the incidence, transmission, and severity of disease and the potential impacts on people. Ensure the plan develops potential transmission and infection scenarios. Plan accordingly to scenarios identified in relation to your organisation’s capacities, sharing information, and collaborating with other health actors. Ensure coordination with partners to cover gaps and needs.
Forecasting and pre-positioning essential medicines and devices support the potential to source locally produced items in a timely manner, that can be assessed to ensure they are both high quality and environmentally sustainable. This can help reduce international transportation of essential medical products for outbreaks whilst also supporting early control of disease outbreaks. In turn, early control of outbreaks can allow for better and more efficient general management, including proper waste management measures.
An NGO working in Pakistan with communities vulnerable to earthquakes reported including community members in designing earthquake preparedness plans. The community members included strengthening buildings and infrastructure against collapse and preparing for re-use of crisis waste in any reconstruction.
Many humanitarian responders train women on potential water contamination and effective storage and preventing disease transmission.