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Environmental quality is always important, but plays an even more important role in determining the health status of a disaster-affected population. Some important steps prevent further environmental deterioration and achieve gradual improvement include:

a. Disposal of excreta and wastewater: In order to prevent pollution of soil and water sources, as well as the proliferation of undesirable fauna, sanitary control measures for the elimination of excreta and wastewater must be put in place. The method selected for a given area or region will depend on many factors, including the local geology and hydrogeology, the culture, the communities’ preferences, what materials are available locally, and cost.

• When sanitation services are unavailable, latrines (individual, collective, or portable) need to be built, taking into account the type of soil, topography, and user access, as well as surface water and groundwater in the vicinity.
• If the land does not lend itself to the construction of latrines (for example because the soil is rocky or the water table is high), raised latrines should be set up (above ground level) with interchangeable receptacles. Excreta can then be transferred to a pit located in an appropriate location, where it can buried immediately.
• Sophisticated but unsustainable technologies should be avoided.
• The population should be given information and instructions on proper use and maintenance of latrines.

Read more about sustainable sanitation here.

Another potential source of contamination is domestic wastewater, wastewater from medical facilities, and stagnant water, including rainwater and floodwater. The population should be involved in eliminating these sources of risk. This is particularly important at the points from which safe water is being drawn, and in areas of human activity and settlement in general.

In the chapter beginning on page 79 of the Sphere Handbook you will find referential minimum standards for proper excreta disposal as well as for proper wastewater management.

b. Appropriate disposal of solid wastes: Solid waste includes domestic trash, animal corpses, and other waste materials that, when they accumulate, promote the appearance and spread of vector-borne diseases. The characteristics, volume, composition, and disposal of waste change when disaster strikes. Even the packaging used to deliver assistance to victims can significantly increase a community’s quantity of solid waste. In the event of an earthquake for example, the great quantity of waste that is created generates a need for a specific approach to handling rubble and the residue of demolition activities. Read more about solid waste management in the WHO technical notes.

The urgent actions that must be undertaken to manage solid waste include:

• Collecting and transporting the waste
• Establishing procedures for the management of domestic waste, providing the population the receptacles to collect household garbage, with instructions that emphasize the importance of avoiding indiscriminate disposal of refuse.
• Pay special attention to the management of hazardous solid waste, particularly from health care facilities.
• Establish procedures for the treatment and final disposal of waste.

Read the OCHA report on managing solid waste in the Turks and Caicos Islands after Hurricane Ike (2008). Learn more about these issues in the disaster waste management guidelines.

c. Monitoring food safety: Food safety measures must be instituted to help prevent the spread of disease due to food that is in poor condition or has been processed badly. Surveillance should cover the entire food chain, from point of origin to consumption. These measures are most important at temporary shelters, where it is possible to exercise more control:

• Receipt: The quality of food products that are received should be checked for their state of preservation and/or expiration dates.
• Storage: Strict hygiene measures should be established for food storage and they should include periodic checking of the state of the food stored.
• Preparation: Strict sanitary measures should be put in place for food preparation and consider the site, the utensils used in preparation, and personal hygiene by those preparing food.
• Consumption: People should be made aware of the importance of hygienic habits and the cleanliness of food utensils.

Consult WHO’s manual Five keys to safer food.

d. Disposal of dead animals: Although in most cases dead animals are considered to be a public health risk only under specific conditions, measures must be established for their proper disposal. However, this does not take precedence over other sanitation issues.

e. Vector and rodent control: Deteriorating environmental conditions facilitate the proliferation of vectors that transmit disease. Hence, simple measures should be taken to keep these vectors at a low enough level to prevent risk to human health. Measures include:

• Educating and raising the awareness of the public so that breeding sites for vectors are eliminated in and around dwellings, and also providing information on measures to prevent infection, including personal hygiene;
• Active identification and elimination of vector reproduction sites, including sanitary waste disposal;
• Interior and exterior fumigation with insecticides that have residual effects;
• Providing the population means of protection from disease vectors, as well as instructions on their control and elimination; and
• Taking maximum sanitary measures where people are crowded together, as occurs in field refuges.

Chapter 8 on environmental health management in the PAHO manual Natural Disasters: Protecting the Public’s Health provides further information on vector control measures.

f. Hygiene promotion: Emphasis should be placed on actions that the community itself can take to prevent diseases associated with poor sanitary conditions. The community should be given the knowledge, practices, and resources to take these important measures. Crucial for this type of effort is a good knowledge of local cultural practices and effective use of all available means of communication.

Read more about water, sanitation and hygiene.
 

From the public health perspective, urgent measures should be put in place to reduce the exposure of the population at refuge sites to risk factors for their health, namely:

• Timely evaluation to determine conditions where people are living, to ascertain needs, and to take necessary corrective action.
• Acting to guarantee a safe water supply and basic environmental sanitation.
• Organizing the community at the refuge so that it assumes responsibilities for operating the site.
• Health care in the form of primary care, preventive medicine, surveillance of communicable diseases, and health promotion.
• Mental health: detection and early care of mental health problems.

The aftermath of emergencies and disasters can produce psychosocial disturbances that sometimes exceed a population’s capacity to manage or cope. The victims themselves are not the only ones affected. Health workers, search and rescue groups and other first responders, volunteers, and others who assist in response efforts also are often subjected to an enormous emotional burden in carrying out their tasks.

Many populations with special needs require pre-established measures to lessen the impact of disasters and emergencies. Developing Due to the amount of preparation that they require, most of these measures should be defined and prepared for in normal times. They also require active participation by family members and community. In disaster situations, care should be taken to treat people with special needs in the differentiated ways called for, namely:

• Persons with visual disabilities: Ensure that they receive guidance, and facilitate their access to safety and assistance. Remember that it may be necessary to include guide dogs in assistance plans.