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Improvising health care after Typhoon Haiyan

MANILA, 20 November 2013 (IRIN) - Ongoing assessments of healthcare facilities damaged by Typhoon Haiyan (locally known as Yolanda), which made landfall on 8 November in the Philippines, show some 41 percent, mostly hospitals, were not functioning as of 19 November, forcing patients and their providers to improvise life-saving care.

At least 117 health facilities in seven provinces in central Philippines were damaged by the category-5 typhoon. Most are primary healthcare facilities, known as barangay health units (BHU), which cater to the population’s most basic healthcare requirements, according to a recent Department of Health (DOH) report.

The estimated total cost of damage to healthcare facilities in the provinces of Leyte, Antique, Iloilo, Capiz, Aklan and Cebu in the Visayas region, and Palawan in Luzon region, is some US$5 million, but the DOH said some areas are still impassable and out of reach for assessors, making this a preliminary estimate of damages and human suffering.

Completely damaged

Out of the 117 hospitals surveyed, 43 are completely damaged, mostly in Eastern Visayas, which suffered the worst of the typhoon’s 315km/h sustained winds. The hospitals that survived the typhoon could not function during the early days of the typhoon’s aftermath as health workers attended to their own wounds and families.

Typhoon Haiyan has affected at least 10 million people and killed at least 4,000 others, based on the latest figures from the National Disaster Risk Reduction and Management Council (NDRRMC).

Nearly 400,000 people are being housed in some 1,500 evacuation centres, while over four million other displaced are living with relatives or friends.

Improvising care

Health workers are often working amid rubble to help people in need. “The local health workers created a safer area to cater to the needs of the population, but the capacities are small because equipment and supplies vanished,” said Gegham Petrosyan, health coordinator for the International Committee of Red Cross (ICRC) in the Philippines.

The ICRC has focused its operations on Samar island in Eastern Visayas, where it will take three to six months to rehabilitate tertiary hospitals capable of handling more complicated cases, making it all the more important to bolster local primary healthcare facilities. “The commitment is to bring them to their pre-typhoon level. We want to activate the barangay health units to a capacity to address the needs of the population,” Petrosyan said.

Eric Tayag, the DOH assistant secretary and spokesperson, told IRIN the government aims to repair or rebuild health facilities rendered non-functional by the typhoon within one year, and to put up “makeshift” facilities in the meantime.

Petrosyan said more injuries have been recorded as people started clearing debris in devastated areas.

Médecins Sans Frontières’ (MSF) emergency coordinator Natasha Reyes said in an interview from Cebu on 18 November that cuts and wounds from nails, “from stepping on the wreckage of buildings”, made tetanus vaccinations a top priority for the agency’s work on Samar, Leyte and Panay islands.

On 19 November, MSF ran three outpatient clinics on Panay island in Western Visayas, where the typhoon destroyed many boats, the main form of transport in the coastal region and therefore the usual way of seeking healthcare.

A number of typhoon survivors with chronic diseases have reported running out of life-sustaining medicines, said Reyes, who noted that patients have also been reporting “mysterious pains” with possible psychological underpinnings.

“Many people are too busy to absorb what has happened,” she said in a recent statement. “I met a woman who had lost her daughter and mother in the typhoon. She told me about in a very matter-of-fact way, and said that she cried when it happened, but has not cried since. I think many of the effects of the disaster will be delayed. Our teams will be busy for some time,” Reyes noted.

International aid

International medical teams have helped plug the gap in local care, said NDRRMC executive director Eduardo Del Rosario. “A lot of health workers have flown to the devastated islands. Health units have been established on a temporary basis. We also have the American aircraft carrier that has undertaken even major operations,” Del Rosario told IRIN.

MSF had 160 international staff on the ground as of 20 November. Field hospitals are being set up by the Canadian Red Cross (with support from the Norwegian and Hong Kong Red Cross), the Royal Australian Air Force and the Israeli Defence Force. Save the Children has one medical team that is soon to deploy by helicopter to more remote islands.

Additional stand-by medical teams include staff from Korea, South Africa, Russia, Germany, Japan and Malaysia.

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Theme (s): Health & Nutrition, Natural Disasters,

[This report does not necessarily reflect the views of the United Nations]

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