There are environmental factors affecting the way in which health items are provided or distributed. These include transportation of first aid kits as well as the provision of training. For example, high levels of humidity or rainfall might make it necessary to wrap items in impermeable packaging or tarpaulins, and how are these disposed of after the distribution. This may also include the state of roads, which may be affected by landslides or extreme weather events that make transportation by road impossible. There are also different climatic or environmental factors that might increase the use of health items or accelerate the deterioration of stored essential medical items.

Ensure traditions are safeguarded if needed, such as different transportation vehicles for men and women.

Air pollution
Soil pollution
Water pollution
Deforestation
Natural resource depletion

• Transportation of staff for training and of first aid kits for injured animals increase air pollution and release of greenhouse gases.
• First aid materials need to be properly stored in order to avoid contamination of water sources and soil while at the same time preserving the aid items long-term. Also, the accumulation of packaging, containers, and bottles may result in contamination of water sources and end up in rivers, lakes, and the ocean.

• Availability of safe essential medicines and medical services usually requires storage and transport. Transportation activities usually burn fossil fuels that impact the environment by reducing air quality and creating air and noise pollution from combustion, and contribute to climate change, mainly from carbon dioxide (CO2) and water vapor (H2O) products. In addition, air pollution can increase respiratory diseases. There is a potential increase in waste from the packaging. In some settings that require the use of boats, transportation can also cause water pollution.
• Delivery of items can have negative effects on the environment if not well planned, or if the needs and behaviour of individuals and communities are not appropriately assessed. Good medicine management also prohibits unsafe or expired medicines, which helps avoid immediate waste. When delivered items do not match with the cultural preferences of affected communities, items may be unneeded, unused, and wasted, or may be re-sold in local markets so that targeted people can use the money to purchase the items they really need. Also, when items are used in locations where there is limited local waste management and recycling infrastructure waste can end up creating breeding locations for disease vectors; causing injury to animals and human health; and degrading or being burned to cause water, soil, and air pollution.

• Use of local staff, local procurement of medicines where appropriate, and minimising transport when possible.
• Where possible source local sustainably produced items
  Properly identify needs and base aid items on culture and context or work with communities to help them understand, accept and adopt items that are more sustainable.

• When acquiring or moving staff the environmental impacts of transportation and energy used need to be assessed. Recruiting local staff will increase the availability of local knowledge, benefit the local economy, contribute to the local economy and benefit the environment by reducing air pollution from travel and reduced consumption and energy use that are usually associated with expatriate staff.
• Organise a staff vehicle sharing for travel to reduce vehicle emissions. Ensure not only the most efficient mode of transportation but also the least detrimental for the environment (e.g.: use one big truck instead of several small vehicles).

• Many humanitarian responders now coordinate community health visits to minimise the total number of journeys.
• First aid materials need to be properly stored in order to avoid contamination of water sources and soil while at the same time preserving the aid items long-term. Also, the accumulation of packaging, containers, and bottles may result in contamination of water sources and end up in rivers, lakes, and the ocean.

• The proportion of information shared through less polluting methods such as radio or television.
• The proportion of local staff to ex-pats.
• Percentage of delivered items that were produced locally

Prevention of environmental damage

• Time and expertise to assess environmental impacts. Time and expertise to amend recruitment policies and procedures. Time and effort to encourage or require vehicle sharing and to support the increase of safe efficient public transport.
• Time, resources, and expertise for research, design, and implementation.