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Drinking water supply is at the core of both, humanitarian action in times of crisis, as well as national policies for regular and emergency supply. In countries with a continuous water supply, the population mostly relies ingenuously on the permanent availability of tap water due to high supply standards. In case of a disruption in the drinking water infrastructure, minimum supply standards become important for emergency management during disasters. However, wider recognition of this issue is still lacking, particularly in countries facing comparably fewer disruptions. Several international agencies provide guideline values for minimum water provision standards in case of a disaster. Acknowledging that these minimum standards were developed for humanitarian assistance, it remains to be analyzed whether these standards apply to disaster management in countries with high supply standards. Based on a comprehensive literature review of scientific publications and humanitarian guidelines, as well as policies from selected countries, current processes, contents, and shortcomings of emergency water supply planning are assessed. To close the identified gaps, this paper flags potential improvements for emergency water supply planning and identifies future fields of research.

Objective: To assess perioperative complications and 90-day mortality of radical cystectomy (RC) in elderly patients with muscle-invasive bladder cancer (MIBC). Materials and Methods: This is a retrospective, multicentre (n = 11) study of a consecutive series of patients ≥75 years who underwent RC for MIBC between 2006 and 2010. Medical, surgical and wound complications were graded according to the modified Clavien-Dindo classification. Results: A total of 256 patients with a mean age of 79.6 years (range 75.0-86.6) were analysed. Urinary diversion with the use of bowel was performed in 79.5% and ureterocutaneostomy in 20.5%, with a higher proportion in the ≥80 cohort (32.2 vs. 14%; p = 0.001). 41.4% of patients had an uneventful postoperative course (Clavien grade 0) and 26.6% developed severe complications (Clavien grade III-V). In a multivariable regression analysis, the Charlson comorbidity index (odds ratio 1.5 per unit increase; p < 0.001) and the body mass index (odds ratio 1.13 per kg/m² increase; p = 0.015) were predictors for the development of complications. The 90-day mortality rate was 9% and the independent correlates thereof were the development of severe medical complications (p = 0.004), the American Society of Anesthesiologists (ASA) score (p = 0.03) and age (p = 0.005). Conclusions: Morbidity and 90-day mortality of RC in the elderly remain substantial. The interrelation between comorbidity, complication rate and 90-day mortality underlines the need for a comprehensive geriatric assessment of elderly patients with MIBC in whom RC is indicated.