Cooper Brittany, Behnke Nikki L, Cronk Ryan, Anthonj Carmen, Shackelford Brandie Banner, Tu Raymond, Bartram Jamie
The Water Institute at UNC, Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7431, Chapel Hill, NC 27599, United States.
ICF, 2635 Meridian Pkwy Suite 200, Durham, NC 27713.
Sci Total Environ. 2021 Mar 25;762:143136. doi: 10.1016/j.scitotenv.2020.143136. Epub 2020 Oct 16.
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. To address this gap in research, we conducted a systematic scoping review of environmental health conditions, exposures, and outcomes in transitional displacement settings, as well as reported obstacles and recommendations for improvement. Eighty-eight publications met the inclusion criteria. Water supply was the most frequently discussed environmental health topic. Overcrowding was the most common risk factor reported, Vibrio cholerae was the most common pathogen reported, and diarrhea was the most commonly reported health outcome. Obstacles and recommendations were categorized as institutional, political or implementation-based. Identified knowledge gaps included minimal information on setting logistics and on topics such as menstrual hygiene, oral hygiene and fomite contamination. In order to improve environmental health conditions in transitional displacement settings, all levels of government and non-governmental organizations should increase collaboration to improve resource provision. This study is the first to report on environmental health conditions in this important time of transition between the emergency and protracted stages of displacement.
2019年，每天有3万人因冲突、迫害和自然灾害被迫离开家园。85%的难民生活在发展中国家，他们常常面临环境卫生服务资金不足和供应短缺的问题。许多流离失所者在流离失所事件发生很久之后仍生活在难民营和其他临时定居点。然而，关于过渡阶段（联合国难民事务高级专员公署定义为流离失所后6个月至2年）环境卫生状况的证据很少。为了填补这一研究空白，我们对过渡性流离失所环境中的环境卫生状况、暴露因素和结果进行了系统的范围界定审查，并报告了存在的障碍和改进建议。88份出版物符合纳入标准。供水是讨论最频繁的环境卫生主题。过度拥挤是报告最常见的风险因素，霍乱弧菌是报告最常见的病原体，腹泻是报告最常见的健康结果。障碍和建议分为机构性、政治性或基于实施方面的。已确定的知识空白包括关于安置点后勤以及月经卫生、口腔卫生和污染物污染等主题的信息极少。为了改善过渡性流离失所环境中的环境卫生状况，各级政府和非政府组织应加强合作以改善资源供应。本研究首次报告了在流离失所紧急阶段和长期阶段之间这一重要过渡时期的环境卫生状况。
