Environmental health in forced displacement: A systematic scoping review of the emergency phase

• Published in: The Science of the total environment Vol. 714; p. 136553
• Main Authors: Shackelford, Brandie Banner, Cronk, Ryan, Behnke, Nikki, Cooper, Brittany, Tu, Raymond, D'Souza, Mabel, Bartram, Jamie, Schweitzer, Ryan, Jaff, Dilshad
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 20.04.2020
• Subjects: Emergencies; Emergency; Humanitarian; Humans; Hygiene; Internally displaced person (IDP); Menstruation; Migration; Refugee; Refugees; Sanitation; WaSH; Humanitarian; Refugee; Emergency; Internally displaced person (IDP); Migration; WaSH
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2020.136553

There are 70.8 million forcibly displaced people worldwide, including internally displaced persons, refugees, and asylum seekers. Since mortality rates are highest in the first six months of displacement, the provision of adequate services and infrastructure by relief organizations is critical in this “emergency phase.” Environmental health provisions such as adequate water supply, excreta management, solid waste management, and vector control measures are among those essential services. We conducted a systematic scoping review of environmental health in the emergency phase of displacement (the six months following first displacement). A total of 122 publications, comprising 104 peer-reviewed and 18 grey literature publications, met the inclusion criteria. We extracted data relating to environmental health conditions and services, associated outcomes, and information concerning obstacles and recommendations for improving these conditions and services. Despite the fact that most displaced people live outside of camps, publications largely report findings for camps (n = 73, 60%). Water supply (n = 57, 47%) and excreta management (n = 47, 39%) dominate the literature. Energy access (n = 7, 6%), exposure to harsh weather from inadequate shelter (n = 5, 4%), food hygiene and safety (n = 4, 3%), indoor air quality (n = 3, 3%), menstrual hygiene management (n = 2, 2%), dental hygiene (n = 2, 2%), and ambient air quality (n = 1, 1%) are relatively understudied. The most common health outcome attributed to inadequate environmental conditions in the included publications is diarrhea (n = 43, 35%). We found that organizations and governments often embrace their own standards, however we call for policymakers to adopt standards no less rigorous than Sphere for the emergency phase of displacement. Although other reviews examine water, sanitation, and hygiene interventions in emergencies, this is the first systematic review of environmental health more broadly in the first six months of displacement. [Display omitted] •Despite the fact that most displaced people live outside of camps, most findings are from camps (n=73, 60%).•Included publications most commonly report on water supply (n=57, 47%) and excreta management (n=47, 39%)•Over a third of the included publications (n=43, 35%) attribute diarrhea from inadequate environmental conditions