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Key environmental issues linked to health in a humanitarian response

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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.

Resources

Case Study, Guideline, Tool, Training Material

UNEP-Norway Partnership Training Resource Library for Reducing Pollution Risks Associated with the Energy Sector

Credit:  Unsplash.com/David Thielen   Finding substantial reserves of oil and natural gas offers significant opportunities for the social, economic and political development of any country. However, oil & gas exploitation can also pose significant risks, from major accidents as well as from routine operations that cause serious environmental…

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Guideline

Disaster Waste Management Guidelines (DWMG) Online

Welcome to the online edition of the Disaster Waste Management (DWM) Guidelines. This section contains the relevant tools and general information for those who plan to deploy on disaster waste management missions and those dealing with disaster waste management. We recommend reading the Disaster Waste Management Guidelines…

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Report / Study

Gender, Climate & Security

The impact of Climate Change has already increased the insecurity of vulnerable communities in serval regions across the globe, including exacerbating the loss of livelihoods, food insecurity, competition over scarce resources, human mobility and political and economic instability.

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Guideline

Compendium of Technologies for Treatment/Destruction of Healthcare Waste

The UNEP division of Technology, Industry and Economics International Environmental Technology Centre has written a compendium which outlines the process of technology selection in the health-care sector based on UNEP's Sustainable Assessment of Technologies (SAT) methodology.

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Policy Document

Environment in COVID-19 humanitarian response in Latin America and the Caribbean

UN Environment Programme (UNEP) Latin America and Caribbean Office have developed a policy paper setting out the response services that UNEP can offer in the region. Both through continuing support to ongoing emergencies and response to new requests for support from governments and other UN agencies, UNEP will focus support…

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Guideline

Safe management of wastes from health-care activities

This document highlights the key aspects of safe health-care waste management to guide policy-makers, practitioners and facility managers to provide services in health-care facilities. It is based on the comprehensive and detailed WHO handbook Safe management of wastes from health-care activities.

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Guideline

Overview of technologies for the treatment of infectious and sharp waste from health care facilities

This study, conducted in 2019 by WHO, looks at safe health care waste management, including segregation, collection, transport, treatment and waste disposal and understands that it is fundamental to wider efforts to provide quality and safe health care.

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Guideline

UN Environment: Quick guides on how humanitarian action can minimize environmental impacts

The 'Quick guides' contain key guidance on environmental issues relevant to six sectors of Food Security and Agriculture Sector, Basic Needs Sector, Health Sector, Education Sector, Protection Sector and Livelihood Sector of humanitarian response to population displacement. They underscore the opportunities to minimize negative environmental impacts during humanitarian action.

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Guideline

Asia Pacific – DWM guidelines

The Disaster Waste Management Guidelines for Asia Pacific, published by the Japanese Ministry of the Environment, is developed to enhance preparedness for disasters by exchanging information, awareness and human resources during normal (non-hazard) times. The guidelines aims to provide a practical tool during a potential disaster as well as in…

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Guideline

UNDP – Guidance Note on Debris Management

The focus of the UNDP Guidance Note on debris management is to provide urgent post-crisis and post-disaster assistance. It offers practical advice to UNDP Country Offices on how to plan, design and implement short-term projects that effectively connects governments and communities in the process of assessment, clearance, recycling and management…

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Guideline

UNDP – Guidance Note on Municipal Solid Waste Management in Crisis and Post-Crisis Settings

The UNDP Guidance note forms part of a series of UNDP's signature products that aims to respond and support early recovery in immediate crisis and post-crisis contexts with practical advice and guidance to UNDP Country Offices. The objective is to provide guidance on how to plan, design and implement projects…

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Tool

The Rapid Environmental Impact Assessment in Disasters (REA) tool

The Rapid Environmental Impact Assessment in Disaster (REA) is a tool to identify, define, and prioritize potential environmental impacts in disaster situations.

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Policy Document

Sphere Handbook Health Standards

The Sphere Minimum Standards for Healthcare are a practical expression of the right to healthcare in humanitarian contexts. The standards are grounded in the beliefs, principles, duties and rights declared in the Humanitarian Charter, including the right to life with dignity, protection, security, and the right to receive humanitarian assistance…

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Guideline

USAID sector environmental guidelines: Healthcare waste

The guidelines outline the typical environmental impacts of healthcare waste and provides options on how to mitigate or prevent these.

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Guideline

Visual Field Guide: Healthcare waste

Quick identification of serious environmental concerns in small-scale sanitation activities.

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Guideline

Disaster Waste Management Guidelines

These guidelines were developed with the aim of supporting the full cycle of disaster waste management, from risk reduction and contingency planning through to emergency planning response following a disaster or conflict.

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Case Study

Lessons Learned Bulletin on Pandemic Measures and Chemical Process Safety

This factsheet is a special issue from the Lessons Learned Bulletin (LLB) and intends to raise awareness of risks associated with shutdown and startup of industrial sites where dangerous substances are present.

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Tool

Glossary of Health Emergency and Disaster Risk Management Terminology

WHO has conducted a Glossary that aims to enable all actors, sectors and communities to work together more efficiently. The glossary is developed to remedy the lack of standardized terminology in the field of Health Emergency and Disaster Risk Management (Health EDRM).

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Report / Study

Evaluating Climate Vulnerability in Humanitarian Hotspots

This study, conducted in 2019, focuses on the definition of climate vulnerability with operational and political perspectives and delivers guidelines for assessing climate vulnerability in long-term crises, such as in conflict-affected countries and recurrent disaster-prone areas. The research draws on an extensive academic literature review in the fields of biology,…

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Guideline

USAID – Sector Environmental Guidelines: Healthcare Waste – Full Technical Update, 2019

Healthcare Waste - within the Sector Environmental Guidelines (SEGs) prepared for USAID under the Agency's Global Environmental Management Support (GEMS and GEMS-II) Program and Environmental Compliance Support (ECOS) Contract.

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Policy Document

Climate Change and Health: An Urgent New Frontier for Humanitarianism

A policy briefing provided by the international research collaboration The Lancet Countdown, offering an updated analysis of the intersection of climate change and global health. The briefing integrates the findings of the 2018 Lancet Countdown on Climate Change’s International Report with MSF’s documented on-the-ground experiences.

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Tool

WHO UNFCCC – Climate and Health Country Profile Project

The WHO UNFCCC Climate and Health Country Profile Project provides country-specific estimates of current and future climate hazards. It also identifies the effects of climate change on human health and identifies mitigation and policy change actions. The data is collected via biennial surveys and was completed in 2017.

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Tool

The Knowledge Hub on Health and Migration

The Knowledge Hub on Health and Migration is a joint effort committed to building expertise on the public health aspects of migration and making information in this area widely available. The Hub provides tool kits, training materials, reports and schooling to better prepare for the health needs which arise during…

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Case Study

Mozambique Shelter Cluster & UNDP – General strategy for risk reduction linked to asbestos cement

This strategy addresses awareness, assessment and management of asbestos following Cyclone Idai in Mozambique (2019). Drawing from the case study, the strategy provides a general outline of key steps to raise awareness; design trainings; and plan and implement safe removal, handling and disposal of asbestos in emergency situations.

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Case Study

UNEP – Managing post-disaster debris: the Japan experience

A report conducted by the UNEP regarding the international expert mission to Japan targeting the management of post-disaster debris.

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Case Study

UNHCR – Disaster Waste Recovery, Guidelines for Implementing Cash-for-Work Projects in the Waste Management Sector

The guidelines for implementing Cash-for-Work Projects (CfW) in the waste management sector is an initiative of Caritas, Action Against Hunger and the Danish Refugee Council. They provide guiding principles and criteria for implementing cfW programs in the waste management sector as a means to achieve environmental goals and improve the…

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Report / Study

Conflict Pollution and the Toxic Remnants of War

This document highlights the complex relationship between armed conflict and environmental pollution.

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Report / Study

Environmental health in emergencies and disasters: a practical guide

The guide is targeted to emergency planners and environmental technical staff working in a disaster context. It provides detailed guidance on environmental health activities in the prevention, preparedness, response and recovery stages of an emergency.

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Guideline

WHO: Health response to technological incidents

This WHO page gathers guidance concerning the public health response to technological incidents, e.g. chemical accidents and accidents related to the transport of hazardous goods.

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Guideline

Health & Environment Tools for Effective Decision-Making: The WHO-UNEP Health and Environment Linkages Initiative (HELI)

The Health and Environment Linkages Initiative (HELI) is a global effort by WHO and UN Environment to promote and facilitate action in developing countries to reduce environmental threats to human health, in support of sustainable development objectives.

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Case Study

PAX – Amidst the debris; A study on the environmental and public health impact of Syria’s conflict

A case study of the disastrous environmental and public health impacts due to the ongoing conflict in Syria.

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