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.

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VEHA - Field Implementation Guidance

Water supply, Sanitation and Hygiene Promotion (WASH)
WASH in disease outbreaks and healthcare settings
Infection prevention and control
Infection prevention and control

Infection prevention and control


Environmental factors causing/contributing to the needs and affecting the humanitarian activity

People, flora, and fauna are vulnerable to pollution and disease, including from health waste. Disease may spread amongst and between species.

Healthcare waste that is inadequately managed and disposed of can spread disease vectors. Also, when people live or work in high-density communities, in close proximity to animals, the probability of diseases spreading between species increases.

Gender, age, disability and HIV/AIDS implications

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.


Environmental impact categories

Soil pollution
Water pollution
Natural Resource Depletion
Loss of biodiversity and ecosystems

Summary of Impacts
Summary of potential environmental impacts

Soil and water pollution due to lack of capacities to manage wastewater and excreta from health facilities. Increase of unmanaged solid waste (including the plastic type of waste, medical contaminated waste). Air pollution from poor waste burning practices. Waste piling, harboring disease vectors, spreading disease. Physical injuries and infections from hazardous waste.

Impact detail
Detailed potential environmental impact information

Unmanaged health-related 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 old or contaminated medicines and vitamins, can also lead to unintentional disease transmission if disposed of improperly. Unmanaged solid waste/wastewater/sewerage and faecal sludge can contaminate soils, surface waters, and groundwater. Air pollution can be created from poor waste-burning practices. Physical injuries and infections can be caused by poor disposal of hazardous waste. Some medical equipment contains radioactive materials, mercury, and other hazardous materials. Anesthetics are very potent greenhouse gases.


Summary of environmental activities

Conduct a healthcare waste assessment
Plan for healthcare waste separation and appropriate disposal (see relevant intl guidelines)
Review public waste management capacities. Identify authorized companies and pay them to adequately dispose of healthcare waste or fund adequate waste disposal facilities on sites such as placenta pits, and mini sewage treatment plants.

Detailed guidance for implementing suggested environmental activities

Plan for and fund hazardous waste separation and management with appropriate specialized interventions.

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.

Fund adequate waste disposal facilities on site such as placenta pits, and mini sewage treatment plants. Ensure hazardous waste such as isotopes, radioactive medicines, mercury, anesthetics, and expired drugs are separated and disposed of safely and permanently.

Lessons Learnt
Lessons from past experiences

If solid waste gathered at a healthcare waste facility is not segregated or disposed of properly, insects, flies, rodents, and small animals can spread diseases like rabies and yes, the plague. May seem a bit dramatic but if history has taught us anything, it’s that hygiene and waste management are essential to health.

Parasitic infections caused by improperly disposed of laboratory medical waste is also a risk to hospital workers and the public. Parasites thrive in waste and can be easily communicable to humans through skin contact and respiration. Lung infections such as tuberculosis, pneumonia, and influenza are caused by pathogens released into the air by medical waste.

Meningitis is another risk of transmission via bodily fluids, containing pathogens that trigger inflammation of membranes surrounding the brain and spinal cord.

Activity Measurement
Environmental indicators/monitoring examples

Plan for health waste separation and management is designed with clear resources and capacities

Health facilities’ water management plans include a section on managing waste and grey waters.

Percentage of land area that remains without the negative effects of biological hazards (physical and biological)

Activity status
Main Focus
Focus of suggested activities

Prevention of environmental damage

Mitigation of environmental damage

Resource implications (physical assets, time, effort)

Include planning time involving health facilities manager. Identify where additional resources are needed to support the plan (process and results).

Funding for hospital hazardous waste facilities.

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