BACKGROUND:
Armed conflict along the Thailand-Cambodia border resulted in large-scale population displacement, requiring the rapid establishment of temporary shelters in conflict-affected areas of Thailand.1,2 Most shelters were set up in public facilities such as temples and government buildings that were not designed for prolonged habitation.3 Overcrowding and limited infrastructure raised concerns regarding communicable diseases and environmental health risks.

OBJECTIVES:
To assess overall shelter health risks and disease-specific risks, and to support risk-based prioritization of public health interventions during an acute humanitarian emergency.

METHODS:
A cross-sectional shelter risk assessment was conducted from 15 to 19 December 2025 in temporary shelters located in conflict-affected border areas of northeastern Thailand. A total of 67 shelters were assessed by mobile field teams using a standardized digital risk-assessment tool based on national Surveillance and Rapid Response Team guidelines.⁴ Shelters were prioritized by size, with medium- and large-sized shelters assessed first. Data collected included shelter population size, the proportion of vulnerable groups, environmental health conditions, healthcare availability, disease-surveillance capacity, and disease-specific risk indicators.

RESULTS:
The assessed shelters accommodated 33,080 displaced persons, with vulnerable populations accounting for more than 30% of residents in about one-third of shelters. Overall shelter risk was classified as low in 55.2% and moderate in 44.8% of shelters. Disease-specific assessments identified moderate risk for gastrointestinal illness in 86.6% of shelters, with a small proportion classified as high risk. Risks for vector-borne and respiratory infections were predominantly moderate. Key contributing factors included inadequate waste management, the presence of vector breeding sites, insufficient handwashing facilities, lack of isolation areas, and limited on-site healthcare services.

CONCLUSIONS:
A standardized, risk-based shelter assessment enabled rapid identification of priority health risks and guided targeted interventions in a resource-constrained humanitarian setting. This framework may also be applied in other emergencies involving temporary shelters in non-purpose-built facilities.