From Camps to Cities: The Case for Permanent Water Infrastructure

BILLINGSHURST, England – December 12, 2025 – The world is grappling with an unprecedented displacement crisis. According to the latest figures from UNHCR, the UN Refugee Agency, more than 123 million people were forcibly displaced by the end of 2024, a record high that has nearly doubled in just one decade. What were once intended as short-term havens have morphed into sprawling, decades-long settlements rivaling the size of major cities. Yet, their infrastructure remains stuck in an emergency-response time warp, creating a fertile ground for preventable disease.

In response to this growing crisis, UK-based water purification specialist Hydrachem is sounding the alarm, calling for a fundamental paradigm shift. The company argues that the humanitarian sector must abandon its reliance on temporary water solutions for what are now permanent communities. The current approach, they warn, is not just inadequate—it's actively contributing to a cycle of disease and death that demands an urgent rethink of how we plan and build refugee settlements from day one.

The Anatomy of an Outbreak

The link between inadequate water, sanitation, and hygiene (WASH) and infectious disease is not theoretical; it is a grim reality written in the health records of refugee camps worldwide. In 2024 alone, UNHCR and other agencies battled outbreaks of cholera, measles, and mpox across multiple refugee-hosting countries. In Bangladesh, sprawling camps housing Rohingya refugees reported over 15,000 cases of dengue.

These are not isolated incidents but symptoms of a systemic failure. According to the Africa CDC, the continent saw over 204,000 cholera cases and 3,700 deaths in 2024, with the bacterial infection identified as the “first killer.” In Sudan, where conflict has created the largest internal displacement crisis ever recorded, over 37,500 cholera cases were reported. Kenya's Dadaab refugee camp experienced a staggering 55-fold increase in cholera cases, overwhelming its health facilities. These outbreaks are a direct consequence of contaminated water—a problem exacerbated by overcrowding and a lack of durable sanitation infrastructure.

“We're witnessing something deeply troubling,” commented Nicolas Barbieri, Chief Commercial Officer at Hydrachem. “These settlements now function like cities, but without the essential infrastructure required for people to live safely. The planning and resources allocated to water access often remain at an emergency, temporary level.”

UNHCR guidelines recommend a standard of 20 liters of water per person per day, but many camps fall drastically short. In Malawi's Dzaleka camp, for instance, residents often receive as little as nine liters. This scarcity forces families to use unsafe sources, creating a perfect storm for waterborne pathogens to thrive and spread.

Bridging the Gap with Proven Technology

While the long-term goal is permanent infrastructure, immediate and reliable point-of-use purification remains critical. This is where industrial innovation offers practical, life-saving solutions. For half a century, Hydrachem has been a key partner for NGOs like UNICEF and Médecins Sans Frontières (MSF), supplying technologies designed for the world’s most challenging environments.

Their flagship product, the OASIS Water Purification Tablet, is a prime example of effective, deployable technology. The tablets use Sodium Dichloroisocyanurate (NaDCC), an organic chlorine donor compound recommended by the World Health Organization (WHO) for both emergency and routine water treatment. When dissolved, a tablet releases a measured dose of hypochlorous acid, a potent agent that neutralizes bacteria, viruses, and parasites responsible for diseases like cholera, typhoid, and dysentery within 30 minutes.

Unlike liquid bleach, which degrades quickly and is difficult to dose accurately, NaDCC tablets are stable, lightweight, and easy to distribute, with a shelf life of over five years. This makes them an indispensable tool for both initial emergency deployment and sustained use in protracted crises. By providing a reliable method to make water safe at the household level, these tablets empower families to protect themselves while larger infrastructure projects are planned and implemented.

“We've learned that prevention is always more effective than crisis response,” Barbieri notes. The technology represents a crucial intervention that can immediately sever the link between contaminated water and disease, buying invaluable time and saving lives.

The Economic Imperative for Sustainability

The argument for permanent infrastructure is not just a humanitarian one; it is also economically sound. The long-standing reliance on emergency measures like water trucking is financially unsustainable. This practice, while necessary in the immediate aftermath of a crisis, incurs massive and recurring operational expenditures.

Recent studies provide compelling evidence for the economic benefits of transitioning to permanent systems. Research in refugee-hosting areas of Ethiopia revealed that moving from water trucking to a permanent, utility-managed piped water network—often enhanced with cost-effective solar pumping systems—led to a remarkable 92% drop in water provision costs. In one Ethiopian settlement, the cost per cubic meter of water plummeted from $11.38 to just $0.93 over a decade. Similarly, in Uganda's Rwamwanja settlement, a transition to a piped system cut costs from $1.42 to $0.29 per cubic meter.

These upfront capital investments pay for themselves many times over, not only by slashing operational costs but also by yielding significant public health dividends. The financial burden of treating recurring, large-scale disease outbreaks far outweighs the cost of building robust water systems. By providing a consistent supply of safe water, permanent infrastructure reduces disease, lessens the strain on fragile health clinics, and allows displaced populations to focus on rebuilding their lives.

Furthermore, when designed to serve both refugee and host communities, these integrated water systems can foster social cohesion and prevent conflicts over scarce resources, creating a more stable environment for all.

A Paradigm Shift from Temporary to Permanent

The data, the technology, and the economics all point to the same conclusion: the humanitarian sector is at a crossroads. It can continue to apply temporary patches to a growing number of permanent crises, or it can embrace a development-focused approach that acknowledges the long-term reality of modern displacement.

The first question in establishing a new settlement should no longer be about short-term fixes, but about long-term sustainability.

“The first question when establishing a refugee camp should be: how do we ensure clean water for potentially decades?” Barbieri insists. “We need to stop treating these as temporary problems requiring temporary solutions. People's lives depend on it.”

This requires a coordinated effort among NGOs, governments, and private sector innovators to prioritize investment in permanent water infrastructure from the outset. It means embedding sustainability into every stage of camp planning and management. As the global displaced population continues to grow, acknowledging the permanence of these new “cities” is the first step toward providing their residents with the basic human right to clean water.

Nicolas Barbieri concluded: “When a settlement is going to exist for ten, fifteen or even twenty years, it's deserving of permanent infrastructure solutions. Clean water shouldn't be a luxury in the 21st century, yet for millions living in refugee camps, it remains out of reach.”