Developing a Sanitary Survey Form for Evaluating Refugee Camp Locations

A sanitary survey form was devised based solely, on the camp siting criteria as found in the World Health Organization's Guidelines for Sanitation in Natural Disasters. Three trial forms were used in a pilot study conducted in an Indochinese refugee camp in Thailand. A final, form was then prepared, based primarily on the preferences of sanitarians who used the pilot, study forrns. That final form was successfully used in a thesis research project which compared refugee campsite locations with rates of environmentally-incurred disease. form can be' used in selecting the optimum camp location from among several choices within a given geographical area* ~ Disasters, both natural and manmade, are moderators of man's health and well-being. Morbidity and mortality during such disasters may' be great and the disease and resultant death occurring through the aftermath period'may be significant as well{5). The exodus of hundreds of thousands of Indochinese from their home countries of Cambodia, Laos arid Vietnam exemplifies the aftermath of a man-ir.ade disaster. Additionally, refugees leaving Cambodia were affected by malnutrition and starvation resulting from severe rice crop shortages in the previous four years. For the most part, these people were isolated -fri refugee camps in Thailand, Malaysia and Indonesia. .. ..V •,... Shortly after the establishment of the refugee camps in Thailand, voluntary agencies (VOLAGs) began to provide direct medical, public health and nutritional support. Sanitation was generally provided by VOLAGsJournal of Environmental Health', V. 45 (6) 295-298. Gary A. Shook, International, Rescue Committee, P.O. Box 8269, Khartoum, Sudan. May/June,1983r who contracted with the United Nations High Commission for Refugees (UNHCR) for sanitation services, such as the provision for safe drinking water, refuse disposal and vector control. contracts also included for maintenance'of those services and consultation on basic sanitation and, sanitation education. These services were generally guided by volunteer sanitarians from the United States, • Canada and Thailand. Arriving sanitarians continually remarked about the difficulty in providing sanitation services due to the poor location of the camps. Although general criteria for locating temporary disaster relief camps are found in the World Health Organization (WHO) Guidelines to Sanitation in Natural Disasters'^), those or other • siting criteria were apparently not used in. locating refugee camps in Thailand. Medical and public health professionals believed that the'problerns of sanitation, water supply and drainage in the camps were due to the wrong selection of camp sites. Despite the initial, and often continuing, environmental handicaps, the sanitation levels within the camp's improved remarkably. Using funds as Journal of Environmental Health Vol% no. 6 6#3)f.29f-g8 : generally allocated by the UNHCR, VOLAGs vigorously provided sanitation services*. Drainage was obtained or, where it was not, people were relocated to other areas within the camp. Mosquitos and flies were controlled, sewage systems installed, and safe drinking water provided. health of the refugees also improved, as substantiated by the morbidity and mortality data(3). With rest, nutritious food and improved environmental living conditions, the health status of the Indochinese refugees was also markedly improved and was a frequent topic pf conversation among the staff of the camps. In 1981, a study was begun to assess the effect of locations of the refugee camps on certain morbidity rates in selected Indochinese refugee camps in Thailand. It compared selected morbidities with environmental factors that may have been the cause. For example, the rate of turberculosis was to be compared with the levels of crowding, and malaria was to be compared with the presence of the vector and drainage potential. To make an environmental assessment of the camps, it was necessary to develop and use a sanitary survey form, a common device for such evaluations^, 4). form used has to provide the capability of assigning a numerical value to each of the various environmental factors, such aswater supply quantity or drainage capabilityMethodology Pilot Study*A pilot study'was carried out from June until September 1981 in which three styles of forms were,tested. These forms were based solely on the criteria found in the WHO Guidelines. criteria are not

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