Sanitation planning and management is a complex problem, especially in emergency contexts such as refugee camps. Camp 18 of the Cox’s Bazar refugee camp has over 27 000 inhabitants, who have access to 1931 latrines from which the sludge is treated in a centralized fecal sludge treatment plant. However, with 9 % of residents reporting full latrines and manual sludge transport providers struggling to service all the latrines, new approaches and insights are needed to improve this fecal sludge management system. Therefore, this thesis aimed to investigate and optimize the service coverage of the camp’s fecal sludge transportation system. Firstly, 24 spatial data loggers were attached to the sludge transport barrels to examine the successes and downfalls of the current fecal sludge management system. This spatial data was supplemented with interviews with the desludging team to understand the motivation behind certain decisions. The resulting insights were used to design an optimization model aiming to minimize transportation distance and elevation change. The results of this research highlight the value of spatial data collection when investigating and optimizing large-scale complex systems in emergency contexts. Furthermore, it provides insights into the unique and complex nature of a publicly managed, manual transport, fecal sludge collection system within a refugee camp.