An Environmental Health Evaluation Tool for Locating and Assessing Disaster Relief and Refugee Camps

By Shook, Gary; Fos, Peter | Journal of Environmental Health, May 1993 | Go to article overview

An Environmental Health Evaluation Tool for Locating and Assessing Disaster Relief and Refugee Camps


Shook, Gary, Fos, Peter, Journal of Environmental Health


The location of disaster relief and refugee camps has been shown to have significant effect on the rates of diseases associated with the environment, such as tuberculosis and malaria (1, 2). The location of most camps is often influenced by the political, social, economic or military realities of the host countries, and relief agencies must often choose from among a few sites that may not be optimum. Evidence is shown that no matter how much money is spent on environmental health services, camps in poorer environmental locations may have higher rates of disease associated with the environment than do camps located at better sites (3). The overall, or end, objective of providing good refugee health by optimizing environmental health at a given site can be met in two ways: 1) select the best site to begin with, and 2) provide sufficient environmental services in established camps to offset constraints of the site.

To accomplish the task for this research, that is to establish a weighted value tree for camp evaluation, the following objective were established: 1) interview former and current providers of environmental health services in disaster relief and refugee camps to determine, rate and weight environmental health objectives and their respective attributes; 2) develop a model, a weighted value tree, based upon the normalized weights of those interview-determined objectives and attributes; and 3) test the model in existing relief operations, comparing locations to rates of selected environmentally-incurred diseases.

Methodology

In order to determine optimum camp location from an environmental health standpoint, when two or more locations are available, and to assess water and sanitation services in existing camps, a weighted value tree was identified as a potential candidate for providing that assessment. This form of decision analysis has had previous applications which have demonstrated its capability in prioritizing environmental services and resource allocation (4, 5, 6). The objectives of this research were met by modifying the procedure proposed by Edwards and von Winterfeldt and Edwards (7, 8).

Step 1. Rank the environmental health objectives in order of importance. Then rank each objectives' attributes. An example of an environmental health objective is "adequate water." Two measurable attributes of this objective would be an optimum quantity of water and sufficiently good quality of water.

Step 2. Weight the objectives and attributes in importance, preserving ratios. Start by assigning a "10" to the least important objective or attribute. Then rate the objectives or attributes in a pairwise manner.

Step 3. Sum the weights and divide each by the sum. This results in a weighted average ||W.sub.i~~ based on relative importance, or importance weight for each attribute. The individual weights of an objective and for each of its respective attributes, from which the importance weights are determine, are here referred to as normalized weights.

Step 4. Calculate site scores based on the sum scores of the importance weights |SS=|Sigma~ |W.sub.i~(|x.sub.i~)~. The symbol |x.sub.i~ represents each attribute and its respective objective.

Step 5. Decide. Utility theory mandates that the decision alternative or attribute with the higher importance weight is preferred. When selecting a camp site location from among two or more choices, the location with the highest importance weight would be selected. If the exercise is used to assess an existing camp, resources should be allocated to those objectives with the highest importance weights.

Interviews

The interview candidates for this study were identified within international relief agencies. United Nations High Commissioner for Refugees (UNHCR) Program Officers, other international agency personnel and experts who have worked in water, sanitation and health programs throughout the world have first-hand knowledge of the problems encountered in delivery of environmental health services. …

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