Via ReliefWeb, an MSF report: "Some Parts Are Still Devastated": Two Months in Tacloban, Philippines. Excerpt:
Doctors Without Borders/Médecins Sans Frontières (MSF) doctor Natalie Roberts spent two months working in the Philippines, running MSF’s inflatable hospital in Tacloban. Here, she describes her experience.
I arrived in Tacloban a week after the typhoon. As soon as the town came into view from the air, the level of devastation became apparent. The runway was surrounded by debris—cars, bits of tin roofing, broken wood, as well as aid packages and military planes. Airport departures was just a hole in the wall, partially covered by mangled barbed wire.
Driving away from the airport, it looked post-apocalyptic. Few buildings were identifiable as houses, most were reduced to debris. It was really sad to see people picking through the ruins. Even a week after the typhoon, it seemed like people didn’t know what to do with themselves—they felt totally overwhelmed.
We put our bags down in the disused hotel where we were staying and headed to the site chosen for the inflatable hospital: Bethany Hospital’s car park. We had to pick our way along the streets. About one meter had been cleared in the middle of the road. The smell was atrocious. What made it horrific was that you knew it was the smell of dead bodies.
The hospital itself was badly damaged. The rooms were covered in mud and the roof had blown off. We managed to salvage a couple of rooms to run an operating theater, a sterilization unit, X-ray services, and a maternity and neonatal unit. It’s unusual for MSF to run a baby unit in an emergency project, but we expected complicated deliveries and knew patients might not have anywhere else to go. The emergency room and the outpatient and inpatient departments would be housed in the tents.
We worked incredibly hard to get the site cleared. We already had a logistics team of 20, but everyone else got involved—even the surgeons and the medical team.
The hospital kit finally arrived on the evening of November 20. It was pouring rain but we worked through the night to put up three tents. After a couple of hours sleep we returned at 5:00 the next morning to put the rest up. On Thursday the medical team took over, staying all night to put up shelves, assemble beds, and unpack boxes of drugs and dressings. I think I slept for three hours out of 60. The outpatient department opened on Friday, and the rest of the hospital opened on Saturday.
It didn’t take long for patients to start coming. We saw the conditions you would expect after a typhoon—people who had sustained wounds from floating debris, and those with upper respiratory tract infections and worsening of their chronic diseases. There are high rates of hypertension and diabetes in the Philippines anyway, and many people had lost their medication in the typhoon and could not replace it.
Some people had wounds in an advanced stage. The conditions were perfect for infections—it’s hot and wet in the Philippines, and people were wading through dirty water and couldn’t access medical care. We had to perform some amputations.
We also saw many cases of pre-eclampsia—high blood pressure in pregnancy—which can be very dangerous. Under usual circumstances, rates of pre-eclampsia are high in the Philippines, but the stress of the typhoon seemed to have made them even higher.
We dealt with some shocking clinical cases of tetanus. One boy of 17 came in with a deep wound on his shin from the typhoon and the classic signs of tetanus: a locked jaw, muscle spasms, and extreme sensitivity to light and noise. His wound was badly infected, but we couldn’t clean it in surgery because we couldn’t give him an anesthetic—his jaw was so locked and his breathing could have been compromised.
After a week of antibiotics we started taking him into surgery every couple of days to clean his wound. The whole team was following his case, but at the same time we knew that tetanus has a high mortality rate. When he finally walked out of the hospital it was an incredible moment for us all.