Health

The goal of the health sector response during a humanitarian crises is to reduce avoidable mortality, morbidity and disability. Additionally, the sector seeks to restore the delivery of, and equitable access to, preventive and curative health care as quickly as possible and in as sustainable a manner as possible. The health and environmental sectors are closely linked, where the state of the environment, such as air and water quality, directly impacts people’s health and where health sector activities may impact the environment. Environmental health is the branch of public health concerned with all aspects of the natural and built environment affecting human health.

Communicable disease is a common cause of death in disasters and crisis, with disaster-affected people often residing in unsanitary conditions and also more vulnerable to disease due to malnutrition, stress and fatigue. In humanitarian response, environmental issues such as water provision and sanitation, waste management (and control of associated pests and vectors), cooking practices (and associated indoor smoke), chemical risks from damaged infrastructure or vector control, are directly linked to health. (Environmental) health officials are therefore a key collaborator for environmental organizations wishing to support the response.

Some key environmental activities linking to the health sector are outlined below:

Improper management of healthcare waste potentially exposes health care workers, waste handlers, patients and the community at large to infection, toxic effects and injuries, and risks polluting the environment. Healthcare waste from health posts, clinics and hospitals should be segregated and handled in line with international guidance. Designated personnel should be assigned and trained to deal with healthcare waste. The ash from incinerators should be disposed of properly. Expired, poorly labelled or packaged drugs are frequently donated in emergencies but have little value in the response and represent a major public health problem for local authorities. See SPHERE guidelines and healthcare waste guidance for more information.

During an emergency it is often difficult to properly manage solid waste. In many disasters, large amounts of additional waste is created, presenting additional challenges for civil society, local and national governments, private sector and humanitarian and emergency responders. Disaster waste not only impedes access and rescue operations, it also creates additional health risks and may in many instances contain hazardous waste such as fuel oil and asbestos. See the Disaster Waste Management guidelines for more details on waste disposal site planning.

Proper provision of water and sanitation is key to reducing environmental health risks. Facilities should be designed in accordance with relevant standards. Where possible, greywater should be reused. See Chapter 7 and 8 of WHO Environmental health in emergencies and disasters: a practical guide and the SPHERE guidance for more information. 

Where the disaster has caused a rise in vectors or pests such as insects or rodents, vector specialists need to be consulted to develop a plan of action on how best to deal with the issue. Pesticides should be used with care and in line with applicable national legislation and international best practice. See Chapter 10 of the WHO Environmental health in emergencies and disasters: a practical guide for advice. 

When constructing and refurbishing healthcare facilities the use of materials should be considered. Environmentally-friendly and local materials should be used where feasible. The handling and disposal of hazardous waste, (generator) fuel and oils must be properly done in order to avoid contamination of water sources or the soil. 

In case of contamination from a release of chemical materials, public health officials must be involved in the assessment of risk. When it comes to technological hazards, such as chemical and radiological/nuclear hazards, it is important to include public health officials in the design of communication materials in order to properly address but not exaggerate risks. See APELL guidance and Chapter 12 of  WHO Environmental health in emergencies and disasters: a practical guide for advice on proper messaging.

Climate change may exacerbate disaster risk, with strong links to public health, for example the increase in certain pests due to warming. Algal blooms may intensify and malaria-carrying mosquitoes may spread to areas previously not affected by malaria.

In preparedness, health development activities, such as improving water-supply systems, should be conducted in close collaboration with environmental actors.