Emergency Sit-Rep Country (and area of intervention): Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

SUMMARY:

• 62 government, private, and foreign

medical teams are providing direct care

across the regions.

• Delivery of relief is hampered by fuel shortages as well as congested road and air traffic. • Many urban areas are reported to have sufficient relief; government officials request relief agencies explore regions

that are more rural. Photo: Members of International Medical Corps Core

Emergency team in Homonhon

CONTEXT

The death toll from Super Typhoon Yolanda has climbed to 3,974 as of noon yesterday, according to the National Disaster Risk Reduction and Management Council (NDRRMC). The NDRRMC said Yolanda left at least 12,544 persons injured while 1,186 others remain missing. There are 349,870 people in 1,562 evacuation centers. On November 11 President of the Philippines declared a national state of calamity, identifying , , , Iloilo, Capiz, Aklan and are the worst affected areas.

All main airports and seaports are operational, with some minor airports only operating rotary-win or turbo-prop capable planes. The Department of Public Works and Highways have been working to clear secondary and city roads within , now that all national roads have been opened. In , the main highway to the north appears intact and unobstructed, although only 30% of secondary roads are passable.

Power is being restored, although service remains intermittent in the following regions: IV-B, V, VI, VII and VIII. However, fuel shortages remain a constant challenge. In addition, the shortages are causing prices in available gas to spike, as locals are beginning to resell the fuel available at higher prices.

Water pipelines and treatment plants have been repaired in Tacloban although water still requires chlorination to be drinkable. The Government is also working to repair smaller pipes. However, some areas Capiz, Iloilo, and Cebu still lack access to running water.

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

The security situation in Tacloban and Tanauan is unstable. General crime is rampant; riots, road blockages, looting, armed robbery, mob violence and road banditry have all been reported. The main security concerns outside of the above are activities perpetrated by the New People’s Army (NPA), a communist separatist group. On November 14, a ten-day temporary ceasefire was declared by the NPA in an effort to support relief efforts, and is expected to last until November 24.

HUMANITARIAN

Entering the second week after Typhoon Haiyan, the government of the Philippines, other national governments, and relief groups have set to work to assess and respond to the needs of the devastated area.

Local Assessments Cebu: Electricity is limited and communications are unstable. Over 14,000 people have been impacted, and all basic necessities are needed. Tanauan: The city is running low on relief supplies, and there are severe fuel shortages in Leyte and Samar provinces. Of the 40 towns inside Leyte, only 20 have been contacted. Tacloban: Reports indicated that Tacloban Airport hospital is overloaded and the evacuation list is lengthy. CNN reports that an individual died while waiting for airlift evacuation. Government officials have asked relief organizations to spread their work outside of Tacloban, given the current saturation of organizations and need for assistance in more rural areas. Samar/Leyte: Reports indicate extensive looting by organized groups. More police are needed to restore order. There are severe fuel shortages. Island: The northeastern coastline of Panay and the islands were seriously affected. Assessment teams estimated 90% destruction. Immediate needs include shelter, water, and healthcare. Dulag: The health facility has been damaged and medical staff report increasing cases of diarrhea. There is no fuel to transport patients to other health facilities. Burauen: Nearly 100% of homes were damaged or destroyed. The 70-bed referral hospital with surgical capacity was completely destroyed.

Health The provision of health services continues to be a top need for the affected regions. As of November 15, 48 of the 103 health facilities assessed in regions IV-A, IV-B, VII, and VIII were nonfunctional. In Ormoc City, six rural health units and 34 health centers were damaged and subsequently are nonfunctional.

Over 370,000 pregnant and lactating women are in need of pre-natal, post-natal, and child health care. Health promotion and family planning services have also been highlighted as need for the affected population. Assessments and comprehensive data on pregnant and lactating women are lacking.

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

With many health facilities damaged or destroyed, solar-powered refrigerators, diesel generators, and other equipment is necessary for hospitals.

Sixty-two government, private, and foreign medical teams are providing direct care across Regions VI, VII, and VIII. The government and partners have provided essential medicines and tents to operational facilities, but further supplies, as well as manpower, are needed.

WHO highlights principal health issues as follows: wounds and injuries as result of the storm; lack of food water, sanitation and hygiene facilities and related food and water-borne illnesses; problems associated with pregnancy and childbirth; respiratory infections; measles and potential polio; malnutrition, especially in infants and young children; mental health and psychosocial conditions; leptospirosis; vector-borne diseases; and, sexually transmitted diseases.

There are serious concerns of typhoid, cholera, and amoeba, but limited communication is hampering proper reporting.

Nutrition Given the pre-existing nutrition status for the three main regions affected by the Typhoon, there is serious concern for further exacerbation of the nutrition situation. Partners report 1.5 million children under five are at risk of global acute malnutrition. Because of difficulties in accessing affected sites and evacuation centers, nutritional assessments and data are incomplete. The supply of Vitamin A is also reported to be inadequate, and monitoring milk formula donations is difficult. International Medical Corps is assessing the needs in conjunction with Mobile Medical Units and WASH assessments.

Water, Sanitation, and Hygiene Both the government and relief agencies are reporting desperate needs for water, sanitation, and hygiene interventions. Access to safe water is a major issue in many areas, including in Guiuan and surrounding islands. There are no assessments covering the entire affected area, but there are some localized assessments of some affected areas providing information on needs.

The Philippines Red Cross is working in Leyte Province and has established three water bladders, as well as provided water to a medical center and two bus terminals. Other partners have installed water bladders to four municipalities in Capiz, and two water treatment units in Cebu. In Daanbantayan municipality, 1,300 hygiene kits and 800 water kits have been mobilized.

In Ormoc, the Interior Secretary announced on Monday that the water supply system's main pipes are functioning. However, delivery to private homes may still be hindered.

Shelter and Evacuation Centers/Displacement Camps

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

The government estimated that 493,338 homes have been destroyed and 552,622 have been partially damaged. It is reported that tarpaulins, tents, and NFIs are urgent. Many families are salvaging materials from destroyed structures to rebuild.

400 plastic sheets were distributed in Tanauan, and 5,000 tarpaulins were distributed in Tacloban. OCHA reports that 1,562 evacuation centers are currently sheltering 72,986 displaced families (349,870 people.) Host communities are housing an additional 3,651,290 million people (775,155 families.)

The Department of Social Welfare and Development is placing typhoon survivors in Manila with no families in metro Manila in government shelters. Some private individuals are also hosting displaced families.

Within the larger evacuation centers, overcrowding and poor/limited sanitation is an issue. This is especially apparent in Tacloban, where over 56,000 people are living in the Astrodome. 5,000 hygiene kits have been delivery to the Astrodome evacuation centers. There are also reports of poor/limited sanitation in the evacuation centers Pontevedra municipality (Capiz province.)

Food supplies are running low in the Western ' evacuation centers. There are issues in transporting supplies for the centers due to air and road traffic congestion in and out of Tacloban. The Displacement Tracking Matrix (DTM) is in use, and five evacuation centers in Capiz province were profiled using the tool, bringing the total of displacement sites conducting DTM to 23. The Government and UNDAC used an aerial assessment to identify potential re-settlement sites for those identified to be living in hazard zones.

Food Security OCHA estimates that 2.5 million people are in need of food assistance. In Leyte, food assistance has reached 763,410 people in 25 municipalities since November 16th. The government has distributed over 526,000 packs of food covering the entire affected area to date. However, reports indicated that northern Cebu province and Cadiz City require further assistance to cover the needs of the population. The procurement of rice in this area is constrained by limited stocks.

Additionally, there are concerns regarding the December/early January rice seed planting season. Without planting this season, there would be a serious loss of a staple food for local consumption, as well as loss of income, increased debt, and prolonged dependence on external aid. Lack of fuel and vehicles continues to hinder the delivery of food.

Government The Department of Labor and Employment has initiated a P50 million emergency livelihoods program to hire typhoon survivors as part of rehabilitation of affected areas. 12,000 people in Leyte, Western Samar, and Eastern Samar are expected to participate in a 15-day, 260 pesos/day reconstruction program. This program is expected to double in size by January.

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

On Monday, the House of Representatives is expected to vote on a bill to realign the Priority Development Assistance Fund toward Typhoon-affected areas and populations.

International Medical Corps continue to focus on provide health care to the affected population, relying on ongoing assessments and Government input to guide actions.

INTERNATIONAL MEDICAL CORPS’ RESPONSE

As of November 18th, International Medical Corps is operating 4 MMUs in Guiuan, Medellin in North Cebu, Homonhon Island, and Hernani/surrounding area. Please see Annex 1 for a map of International Medical Corps’ interventions. The MMU approach allows flexibility in response and gives the medical teams the ability to reach more remote areas.

In Guiuan, the team is working out of a partially damaged government health facility, and is discussing rehabilitation of the facility with other partners on the ground. Guiuan offers an ideal setting for the mobile medical units to deploy to more rural areas, as well.

On Homonhon Island, off eastern Samar, International Medical Corps’ mobile medical team is treating patients for injuries from debris as well as numerous respiratory infections. The community had yet to see assistance prior to International Medical Corps arriving. Although there were no deaths as a result of the storm, there were many injuries from flying debris and collapsed home. There is a hospital run by nurses and midwives, but the hospital has been without a physician for over a year. It is very low on medicine. The community's livelihood is based on fishing, but the Typhoon destroyed the fishing boats and now the community is lacking in food as well. There had been some rice air-dropped by the military. (Annex 2)

International Medical Corps is providing health care to the injured and ill in Hernani. The town of Hernani suffered 67 deaths, with 7 still missing, and 700 injuries. The town was completely demolished, in exception for a few concrete buildings. There is no drinking water and the residents are using iodine salts. There are no latrines, and open defecation is common. The town depended on fishing as a livelihood, but the 200 boats along the coast are now gone. There is no food because the residents are unable to fish. Trees were stripped, destroying any coconuts. There are some bananas and cassava, and the military has distributed rice. International Medical Corps provided health care to the injured and ill in Hernani. (Annex 3)

International Medical Corps has partnered with Medical Teams International. MTI has deployed medical teams to the Philippines, and these health professionals are now working in the 4 MMUs. In addition, MTI is also shipping medical supplies to International Medical Corps response in the Philippines.

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

International Medical Corps is also working with AmeriCares to obtain medicine and medical supplies to support the MMUs. Massachusetts General Hospital has also dispatched a medical team and will be operating with International Medical Corps MMUs.

International Medical Corps has attended the Health cluster, WASH cluster, and Logistics cluster in Cebu.

Government officials in Tacloban have determined that there are sufficient relief efforts in Tacloban/Tanauan, and have requested organizations seek to assist the affected population elsewhere. International Medical Corps has decided to focus the deployment of MMUs to other underserved affected areas.

International Medical Corps will continue to ramp up the MMU as part of our health response, incorporating mental health, reproductive health, nutrition, gender-based violence protection activities in response to arising needs. WASH interventions are also part of the immediate plan. International Medical Corps will also focus on underserviced regions, especially Iloilo, as well as the more remote affected areas around Guiuan.

Rabih Torbay VP, International Operations [email protected] Maya Bahoshy Chessa Latifi ERU Officer Senior Resource Development Officer [email protected] [email protected]

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

Annex 1: Map of International Medical Corps’ Interventions

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

Annex 2: Hernani Photos

Photo Credit: Margaret Aguirre, International Medical Corps

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Emergency Sit-Rep Country (and area of intervention): Philippines Date: November 18, 2013 Sit-rep No. 5 Covering period: November 15 -18, 2013

Annex 3: Homonhon Island

Photo Credit: Margaret Aguirre, International Medical Corps

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