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«ISSUE 23 INTEGRATED FLOOD MANAGEMENT TOOL SERIES | A DECEMBER 2015 The Associated Programme on Flood Management (APFM) is a joint initiative of the ...»

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integrated flood management tools series

health and sanitation

aspects of flood





The Associated Programme on Flood Management (APFM) is a joint initiative of the

World Meteorological Organization (WMO) and the Global Water Partnership (GWP).

It promotes the concept of Integrated Flood Management (IFM) as a new approach to

flood management. The programme is financially supported by the Federal Office for the Environment of Switzerland (FOEN), the French Ministry of Foreign Affairs and International Development, the National Water Commission of Mexico (CONAGUA) and the U.S. Agency for International Development (USAID).

www.apfm.info The World Meteorological Organization is a specialized agency of the United Nations. It is the UN system’s authoritative voice on the state and behaviour of the Earth’s atmosphere, its interaction with the oceans, the climate it produces and the resulting distribution of water resources.

It co-ordinates the meteorological and hydrological services of 191 countries and territories.

www.wmo.int The Global Water Partnership is an international network whose vision is for a water secure world. The GWP mission is to advance governance and management of water resources for sustainable and equitable development. The GWP network is open to all organizations which recognize the principles of integrated water resources management endorsed by the network.

www.gwp.org Integrated Flood Management Tools Series No.23 version 1.0 © World Meteorological Organization, 2015 Cover photo: Salmonella Typhi, © PHIL / Center for Diseases Control To the reader This publication is part of the “Integrated Flood Management Tools Series” being compiled by the Associated Programme on Flood Management. The Health and Sanitation Aspects of Flood Management Tool is based on available literature and draws on the findings from relevant works wherever possible.

This Tool addresses the needs of practitioners and allows them to easily access relevant guidance materials. The Tool is considered as a resource guide/material for practitioners and not an academic paper. References used are mostly available on the Internet and hyperlinks are provided in the References section.

This Tool is a “living document” and will be updated based on sharing of experiences with its readers. The Associated Programme on Flood Management encourages flood managers and related experts engaged in the evaluation and auditing of flood management programs around the globe to participate in the enrichment of the Tool. For this purpose, comments and other inputs are cordially invited. Authorship and contributions will be appropriately acknowledged. Please kindly submit your inputs to the following email address: apfm@wmo.int under Subject: “Health and Sanitation Aspects of Flood Management”.

Acknowledgements This Tool makes use of the work of many organizations and experts as listed in the references. Special acknowledgements are due to the main author of this publication Ms Michalina Lipa and to Prof Giorgio Cancelliere for sharing relevant bibliography and materials. Ms Madeline Perry as a reviewer as well as Ms Sara Oppenheimer, Mr Luis Roberto Silva Vara and Ms Ranila Rana also provided a valuable contribution to the development of this Tool.


The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Meteorological Organization concerning the legal status of any country, territory, city, or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries.

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1 introduction Flood events are known for their profound capacity to positively or negatively affect humans.

1 Floods improve overall human well-being by providing services such as groundwater recharge, surface-water replenishment, soil-fertility enhancement and a general increase in the value of social–ecological systems. Equally, however, flood events pose a series of diverse health threats, ranging from contaminated water sources to decreased agricultural productivity, especially when communities are vulnerable and lack the capacity to effectively respond to, and recover from, the adverse effects of floods.

In the past decade (2004–2013), 62,879 people lost their lives and about 1 billion people were 2 affected by floods globally. Lives lost in 2013 alone amounted to some 9,816, which was recorded as the highest number of annual deaths owing to floods during the entire decade (CRED, 2012).

Most vulnerable are those living in least developed countries, where resilience is hindered by adverse socioeconomic conditions. Poor populations generally tend to occupy places that are normally left unsettled, such as flood-prone areas or steep slopes, increasing their exposure to flooding (or flash flood). The capacity of these populations to cope with floods, depicted by their weak flood-management policy or complete lack thereof, is usually either non-existent or inadequate because of insufficient resources and means. Coastal and urban settlements are also under increasing pressure from climate change and extreme weather events. More than 50% of the global population is found in densely populated urban settlements and 44% of the global population inhabit the coast (UN Atlas, 2012). These areas are highly exposed to flood hazards. In addition, many people are disproportionately affected by extreme weather events, especially vulnerable groups, which are more likely to suffer damage and have limited capacities to cope with hazardous events (IPCC, 2007).

Flood-related health risks are not limited to injury and loss of life but also trauma, increased 3 incidence of communicable disease, loss of livelihood and disruption of basic services (water supply and sanitation systems) that exacerbate population vulnerability and hinder sustainable development. The changes in water quantity and quality associated with flood events can be influenced by agricultural and urban runoff, sediment loading and chemical, biological and even

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radioactive agent intrusion. These changes alter the availability of clean water – the most basic environmental determinant of human health – and its ability to be used every day: drinkingwater supply, domestic use, bathing, recreation, agriculture, aquaculture, energy and industry.

Flood damage to critical infrastructure, such as water supply and sanitation (WSS) systems, 4 transport routes and health facilities, disrupts the provision of basic human supplies. WSS systems are critical determinants of human health. Non-existent, failing or compromised services therefore pose a significant health risk that reaches beyond local and national borders. Pathogens can invade water sources with a pervasive effect on catchment activities, ecosystems and health. If drinking-water sources become contaminated and no effective treatment can be provided through the water-supply facilities, then flood victims do not have access to safe water and this increases the risk of infection and disease. Where hygiene among displaced populations is poor, water- and vector-borne diseases require special attention to prevent outbreaks and control epidemics. Furthermore, food security is threatened because agriculturally productive floodplains are vulnerable to soil erosion and greater runoff rates during floods, which could result in decreased agricultural productivity and potential contamination of water and food supplies by heavy chemicals, metals, pesticides and animal dejections carried by runoff. Adequately coping with such challenges requires flood planning, preparedness, response and recovery activities that are supported by government and local communities.

The World Health Organization (WHO) defines environmental health as “…all of the physical, 5 chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health.” (WHO, 2012(a)). In this sense, floods can be interpreted as a natural hazard that generates physical, microbial, chemical and radiological environmental health hazards due to disruptions to the environment. Public-health management should, therefore, be considered within the broader context of flood resilience (see Box 1), given that flood-adaptation and mitigation measures that increase flood resilience have greater capacity to protect and improve health outcomes.

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In practice, the critical linkages between flood management, water resource management, 6 public health, WSS systems, climate change and disaster risk reduction are ill defined and remain compartmentalized. A need exists to fill the knowledge gap of public-health vulnerabilities in existing flood-management practices and integrate health and WSS systems before, during and after the flood event. Integrated flood management (IFM) supports this discourse and facilitates flood planning, preparedness, response and recovery activities to reduce environmental health hazards and protect human well-being.

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Integrated flood management is a dynamic and participatory approach to flood management 7 that integrates land and water resource development in a river basin, within the context of integrated water resource management (IWRM) (see Box 2). It aims at maximizing the net benefits from the use of floodplains and minimizing loss of life and livelihood from flood events (WMO, 2009). An integrated – versus fragmented – approach shifts from traditional flood-control practices to proactive participation and collaboration among river-basin stakeholders, holistic management of the water cycle and reduction of risk and uncertainty.

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Integrated water resource management is “a process which promotes the coordinated development and management of water, land and related resources, in order to maximize the resultant economic and social welfare in an equitable manner without compromising the sustainability of vital ecosystems”.

The requirement for stakeholder engagement integrates all actors in the river basin to reduce 8 flood risk collectively, not just those living directly on the floodplain. Various water users, service providers, planners and policymakers across different levels of the public, private and non-governmental sectors engage to develop and implement flood planning, response and recovery activities. This serves the ultimate goal of sustainable development by reducing vulnerability and increasing community resilience in view of the rising risks of flooding and uncertainties that climate change generate.

Due to the complex nature of floods and their hydrological uncertainty, no single or combined 9 measure(s) can provide absolute protection from flood risk. Flood risk is defined by three

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variables: the frequency and severity of the flood hazard, the people and assets potentially exposed to the flooding, and the vulnerability of those people and assets (WMO, 2006) (see Error!

Reference source not found.). Given that floodwaters do not respect geopolitical borders, risksharing between local, municipal, national or transboundary actors is unavoidable in floodmanagement practices.

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Human behaviour and the built-up environment are two significant aspects that influence 10 vulnerability to floods. While floodwater itself is a major cause of death and injury, the spread of disease and availability of safe water in affected communities is largely influenced by the vulnerability of WSS systems and effective health-system management to cope with it.

Strong and responsive institutions that protect public well-being are vital ingredients to reduce flood- and health-related risks during emergency situations. Efficient management involves a multisectoral approach, integrating stakeholders from a variety of agencies (environment, water and sanitation provision, education, health, transport, infrastructure, etc.) which collaborate and communicate effectively to mitigate and manage risk.

Since no single or collective measure(s) can provide absolute protection from floods, emergency 11 preparedness and response plans are essential to manage residual risk. Various levels of government should coordinate to plan and prepare for flood disaster appropriately. More broadly, implementation of national disaster-risk reduction programmes and adoption of an integrated multi-hazard approach can reinforce preparedness, response and recovery activities in the flooded region. The multidisciplinary nature of IFM is pervasive in the sustainable development agenda; linking flood hazards to the larger attainment and consideration of economic, social, cultural and environmental goals (see Box 3). In the context of health and sanitation, mitigation of flood risk thereby mitigates associated health and environmental risks.

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This Tool divides health and sanitation aspects of IFM into three main stages (see Figure 2):

12 Flood planning and preparedness: measures to mitigate the adverse impacts of floods — on human health and environmental health services (WSS, food hygiene, vector control);

Response: operational plan to assess damage and ensure emergency operation of WSS — systems and health-care services during a flood;

Post-flood relief and recovery: action to reinstate water quality, restore essential health — services and rehabilitate critical infrastructure in the aftermath of a flood.

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3.1 Pre-flood baseline health Human health plays an overarching role in hazard preparedness and emergency response.

13 All other considerations being equal, healthy communities are more resilient to the adverse effects of floods than communities with poor health and limited access to health-care services.

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