5 PREREQUISITES FOR INSTALLING SHELTERS

1. Definition of needs

• Evaluate the needs together with the medical team.
• Propose suitable responses in logistic terms: construction, water and sanitation, human resources etc.

2. Site selection

• Identify a site in agreement with the local authorities.
• Take into consideration formal and customary law, and respect local customs.
• Find out about geographical and climatic conditions (whether in an earthquake zone, flood-risk area or basin; strong winds; high ground; rainfall and rainy season; winter conditions etc.)
• Check that water is available nearby.
• Check that there is easy access for supplies and patients.
• Select a larger site than needed.
• Select a site on a gentle slope to facilitate drainage.
• Fence the site off quickly and have it guarded.
• Draw up overall and specific building plans (ground plan, medical facilities, sanitation, access etc.).

3. Technical considerations

• Identify the type of shelter to be used on the basis of timescale, cost, available human resources, means and conditions of transport, existing buildings, locally available materials etc.
• Consider the various standardised solutions: tents (tunnel, winter...), plastic sheeting, local shelters, partitioning of collective centres etc.

4. Human resources

• Identify available national human resources (site foremen, piece-workers, labourers etc.).
• Enquire about the legislation governing hiring of staff.
• Monitor the size of the payroll.

5. Organisation of the work

• Organise the work teams.
• Manage the supply of materials.
• Draw up a phased work plan, based on medical priorities.
• Monitor the site's financial transactions and accounting.

Temporary health facilities

During the emergency phase, the general MSF policy is to instal health facilities under tents.

In the post-emergency phase, it is important to plan the construction of facilities that will improve the level of care provided.

These facilities must be suitable for healthcare, and suited both to the environment (in climatic, ecological, social and political terms) and to the context (building techniques, available skills etc.).

The roof cover must be able to resist wind and bad weather. The walls, light and non-load bearing, can be made of plastic sheeting, corrugated iron, straw, bamboo etc. The floor is either of rammed earth, with or without plastic sheeting, or is covered with smoothed concrete. The lifespan of the building should be at least 2 years, without maintenance during the first year.

MSF REFERENCE DOCUMENT

"Temporary Health Structures Guidelines"

This guide contains all the information you need to set up and maintain temporary health facilities. It contains ground plans and specific sanitation plans for each type of facility, as well as an estimate of the materials required. These plans are examples, designed with the input of medical and logistical experts. Putting them into practice will often require having the skills to adapt them.

This guide has two distinct and complementary functions. On one hand, it can assist the decision-making process during the development of a health facility project and facilitate communication between the field and the capital. On the other hand, it serves as a technical aid for field logisticians regarding site choice, construction methods and sourcing of materials.

FIELD LIBRARY

• L020EMEM02E-P Emergency preparedness - The spirit and the toolkit
• L020EMEM03E-P The priorities - Situations with displacement of population
• L043BUIM07EFP Temporary Health Structures
• L043BUIM06E-P Shelter - Situations with displacement of population
• L043BUIX02E-P Plastic sheeting
• L043SHEX01E-P Transitional settlement for displaced populations
• L043SHEX02E-P Tents, a guide to the use and logistics of family tents
• L043SHEX03E-E Shade nets: Use, deployment and procurement