HWE Lab at EEHF 2026: Three Studies on Water and Health in Emergencies

The Emergency Environmental Health Forum (EEHF), a leading annual scientific meeting on environmental health in humanitarian crises, convened at the International Federation of Red Cross and Red Crescent Societies (IFRC) headquarters in Geneva from 10–12 June 2026. The Humanitarian Water Engineering (HWE) Lab contributed three presentations—on water quality in therapeutic feeding centres during famines, surface water treatment in refugee settlements, and water safety in conflict settings.

HWE Lab Director Dr. Syed Imran Ali presented the Lab's research on potential hazards for paediatric severe acute malnutrition (SAM) patients arising from chemical water quality (CWQ) in therapeutic feeding centres (TFCs). Conducted in partnership with Médecins Sans Frontières (MSF) and McGill's Dr. Jennifer Turnbull (DI Visiting Scholar), the research emerged in response to an unexplained cluster of deaths in a TFC during the 2017 Horn of Africa nutritional crisis.

Children with SAM are among the most vulnerable patients seen in emergencies as their metabolic and physiological processes are profoundly fragile. Therapeutic feeding and rehydration products—fortified milks (F75, F100), ready-to-use therapeutic food (RUTF), and SAM-specific ORS (ReSoMal)—are precisely calibrated for their energy, nutrient, electrolyte, and mineral content. Most are provided as dry powders, to be reconstituted with locally available water—which is often highly mineralized deep groundwater in regions where food and water insecurity overlap. The 2017 cluster raised the hypothesis that such water, if used to reconstitute therapeutic products, could disturb patients' calibrated intakes and contribute to adverse clinical outcomes.

Prompted by this concern, MSF asked the HWE Lab to investigate. The Lab conducted a knowledge synthesis study to test the hypothesis and propose preliminary guidance on allowable water quality in TFC water supplies. Through an adapted water quality risk assessment—comprising an exposure assessment tool, a systematic literature review, and an expert panel of medical, nutrition, and water quality specialists—the study identified four parameters of greatest concern—sodium, magnesium, sulphate, and nitrate/nitrite—and proposed provisional upper limits of intake for paediatric SAM patients. It also proposed a screening threshold based on commonly-measured electrical conductivity (EC >1500 µS/cm) to flag when water likely exceeds those limits. Practitioners at the forum noted that the EC threshold offers a widely-applicable tool for managing these risks in TFCs globally. A number of research institutions and humanitarian organizations expressed interest in joining the next phase: a global assessment of water quality and clinical outcomes in TFCs across high-risk regions.

Civil Engineering PhD candidate and Dahdaleh Scholar Michael De Santi presented online on data-driven optimization of a surface water treatment plant at the Kyaka II refugee settlement in Uganda. Mike demonstrated how treatment processes can be modelled and optimized from routine operational monitoring data using machine-learning techniques, rather than costly pilot testing. Oxfam is now seeking inputs from his work to inform their field programs in Uganda.

Finally, HWE Lab collaborators at Solidarités International (SI) presented the Chlorination Chain Study in Gaza. Dr. Ali delivered the technical section on chlorine decay analysis using the Safe Water Optimization Tool (SWOT), which generated evidence-based chlorination targets specific to the tough conditions in Gaza. The HWE Lab's work with SI in Gaza is now expanding, alongside a new collaboration with MSF there as well.

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