Unintended changes in the environment can lead to increased or reduced health risks. Public health can be affected by disruptions of physical, biological, and ecological systems, including disturbances originating locally and remotely. The health effects of these disruptions may include increased respiratory and cardiovascular disease, injuries and premature deaths related to extreme weather events, changes in the prevalence and geographical distribution of food- and water-borne illnesses and other infectious diseases, and threats to mental health.

The health needs and environmental behaviours of people vary according to their gender, age, physical and health-related abilities, and culture.

Air pollution
Soil pollution
Water pollution
Deforestation
Loss of biodiversity and ecosystems
Natural resource depletion
Impact on wellbeing / mental health

If not done well, triage and trauma care can lead to increases in:
– Air, soil and water pollution
– Deforestation
– Loss of biodiversity and ecosystems
– Natural resource depletion
– Individual and community wellbeing / mental health

Provision of triage and trauma care requires the provision of health facilities and personnel, the use of vehicles, medical equipment, medical devices, and medicines. The procurement, single-use or re-use, maintenance, disposal, and waste management can all lead to many environmental impacts including air, soil, and water pollution from waste piling or burning; deforestation as timber is used for construction or cooking or sterilising; loss of biodiversity and ecosystems from construction activities of waste disposal. Natural resource depletion as trees, water, clay, aggregates is used for construction or water for medical or hygiene purposes. Overall degradation of the environment will affect individual and community wellbeing / mental health.

Careful design and assessment of the local environment to understand:
– local environmental fragilities
– sustainability of natural resources
– community behaviours
– local infrastructure and services
– vehicle use
– procurement of re-usable, locally maintainable equipment and devices
– grey water capture and re-use
– black water treatment
– solid waste management
– recycling
– avoid deforestation
– protect vulnerable biodiversity and ecosystems
– provision of green spaces.

• Provision of triage and trauma care requires careful design and assessment of the local environment to understand local environmental fragilities, availability of sustainable resources; community behaviours, and local infrastructure and services ability to cope with waste and to minimise or clean up pollution.
• This assessment and implementation plan should include the environmentally sustainable provision of health facilities and personnel, the use of vehicles, medical equipment, medical devices, and medicines. It should include the careful procurement of re-usable, locally maintainable equipment and devices. It should include appropriate and effective greywater capture and re-use, black water treatment, and solid waste management, including effective recycling. It should ensure deforestation is avoided and vulnerable biodiversity and ecosystems protected. Natural resources such as trees, water, clay, aggregates, flora, and fauna should be assessed and protected where they are at risk. Community and individual wellbeing should be considered including the provision of green spaces.

Humanitarian responders in the north of South Sudan built health clinics without considering their environmental impact. Some clinics were abandoned due to a combination of lack of natural water resources, unreliable electricity sources, creating an inability to keep medicines cool, and lack of facilities to deal with health waste.

# of health service delivery locations that include a full environmental assessment and plan to minimise environmental impacts

Prevention of environmental damage

Time to assess the local environment, community behaviours, health service requirements, and plan to ensure they have the lowest possible environmental impact.