Journal article

In 2019, 30,000 people were forced to leave their homes due to conflict, persecution, and natural disaster each day. Eighty-five percent of refugees live in developing countries, and they often face underfunded and inadequate environmental health services. Many displaced persons live in camps and other temporary settlements long after the displacement event occurs. However, there is little evidence on environmental health conditions in the transitional phase—defined by the United Nations High Commissioner for Refugees as six months to two years after displacement.

Despite documented health benefits of household water treatment and storage (HWTS), achieving sustained use remains challenging. In prior evaluations of a long-term HWTS program in Haiti, multiple marketing interventions failed to increase use or had prohibitively high costs. Using mobile phones is a potentially cost-effective way to change HWTS behavior. We conducted a randomized experiment to evaluate the impact of sending short-message service (SMS) messages to promote household chlorination in this program in Haiti.

Internally displaced persons (IDPs) are often predisposed to infectious diseases because of the temporary nature of their abode which usually does not have adequate water and hygiene facilities. A hundred (100) samples of hand-washed water taken under aseptic conditions from the hands of the IDPs prior to the emergence of COVID-19 were analyzed using standard bacteriological procedures to determine the total plate and coliform counts, identify the bacterial isolates, and to determine their sensitivity to an array of commonly used antibiotics.

The current Sphere guideline for water chlorination in humanitarian emergencies fails to reliably ensure household water safety in refugee camps. We investigated post-distribution chlorine decay and household water safety in refugee camps in South Sudan, Jordan, and Rwanda between 2013-2015 with the goal of demonstrating an approach for generating site-specific and evidence-based chlorination targets that bet- ter ensure household water safety than the status quo Sphere guideline.

Background. Children in humanitarian situations are particularly vulnerable to diseases such as diar- rhoea. Handwashing with soap can greatly reduce transmission but handwashing rates are often low and traditional interventions ineffective. To aid future intervention design, this study aims to understand the determinants of child handwashing and the key motivational drivers of children’s behaviour within a specific humanitarian setting.

Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients’ houses with chlorine. We conducted mixed-methods evaluations of three household spraying pro- grams in the Democratic Republic of Congo and Haiti, including 18 key informant interviews, 14 household surveys and observations, and 418 surface samples collected before spray- ing, 30 minutes and 24 hours after spraying.

Background: The coronavirus disease (COVID-19) pandemic poses a grave threat to refugees and internally displaced persons (IDPs). We examined knowledge, attitudes, and practices with respect to COVID-19 prevention among IDPs in war-torn Eastern Democratic Republic of the Congo (DRC).

Methods: Mixed-methods study with qualitative (focus group discussions, [FGDs]) and quantitative (52-item survey questionnaire) data collection and synthesis.

Background. Access to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children.

Adequate environmental health services are critical for human rights, health, and development, especially in the context of forced displacement. There are more than 70 million forcibly displaced persons worldwide, most in protracted situations, having been displaced for more than two years. Some live in camps or informal settlements, but most live in urban areas.