THE PHILIPPINES: ONE YEAR AFTER TYPHOON HAIYAN A report on Médecins Sans Frontières’ humanitarian response Typhoon Haiyan, or Yolanda as it is known locally, was the strongest typhoon ever recorded at landfall, ripped through the central Philippines on 8 November 2013. It caused devastation on an unprecedented scale – roofs were ripped off, villages were flattened, livelihoods were swept away and a tsunami-like storm surge claimed more than 6,300 lives and displaced some 4 million people1. In the aftermath of the typhoon, MSF was able to provide emergency assistance to communities on three of the worst-affected islands: Guiuan and nearby towns on Eastern Samar; Tacloban, Tanauan, Palo, Ormoc, Santa Fe and Burauen on Leyte; and Estancia, Carles and San Dionisio on mainland Panay, as well as several outlying islands. This included addressing acute and immediate medical trauma needs; restoring basic medical services and facilities; providing shelter, reconstruction kits, water and sanitation facilities; and offering psychosocial support to both children and adults. One month after the typhoon, the government created a special where its services and expertise are no longer needed. office to oversee the post-Haiyan recovery and rehabilitation Last July, upon completion of the new transitional Felipe Abrigo efforts. After three months, immediate medical and humanitarian Memorial hospital in Guiuan, fully furnished and complete with needs had greatly reduced in some areas, and support for equipment, it was handed over to and managed by provincial overwhelmed public healthcare facilities and the distribution of health office since. A handful of MSF staff stayed on for three relief items were no longer required. Houses had been rebuilt, months providing technical support in running the hospital. By and most of the displaced had returned home, moved to October 2014, MSF officially withdrew from Guiuan. relocation sites or were in temporary housing, although some remained at evacuation sites. Today, in collaboration with the provincial health offices, MSF is providing maternal and neonatal care in Leyte Provincial Hospital In July 2014, the emergency was declared over but a year on, (Palo, Leyte Island) and is involved in rendering another three recovery and rehabilitation work continue. Médecins Sans hospitals fully functional again - Albino Memorial Hospital and Frontières (MSF) has adapted its response to fill medical gaps General MacArthur Hospital, both in Eastern Samar; and and meet the needs of the Filipino people. This has ranged from Abuyog Municipal Hospital in Leyte. providing immediate life-saving care and relief assistance to restoring public health capacity to pre-typhoon levels. MSF has gradually reduced its activities, handed over medical 1 Figures are based on the situation report dated 3 April 2014 of National Disaster programmes to local health authorities and closed projects Risk Reduction Management Council (NDRRMC) of the Philippines. © Yann Libessart/MSF 02 FIGURES AT A GLANCE The numbers given below are an indication of the scale of MSF’s response between 8 November 2013 and 8 November 2014. Around mid-December 2013, 1.5 months after Typhoon Haiyan struck, we had nearly 200 international and 600 national staff deployed. Currently2, we have 10 international and 79 national staff on the ground. Medical activities 1,855 Outpatient consultations (including mobile clinics) 96,611 Tonnes of Patients admitted to hospital 5,224 cargo Emergency room consultations 6,931 Surgical interventions Medical facilities • Minor surgery and dressings 10,515 • Major surgery 1,109 8 Babies delivered 2,445 Facilities Antenatal care 4,728 (tented hospitals and health centres) Patients received mental health support (total) 27,044 • Group sessions 2,178 • Individual consultations 999 Psychological education sessions 462 sessions 7 (16,176 participants) Hospitals rendered fully functional Vaccinations given (total) 29,188 • Measles 14,999 • Tetanus3 6,693 1 • Other (hepatitis, BCG, polio) 7,496 New semi- permanent hospital constructed Non-medical activities Relief kits distributed 71,979 Tents, reconstruction kits, shelter materials distributed 27,463 22 Litres of water distributed 14,473,500 Rural health units rendered Water purification tablets distributed 159,951,000 fully functional (in litres of potable water) People supplied with clean drinking water 86,264 Latrines constructed 96 133 Showers constructed 77 Mobile clinic Emergency nutrition biscuits distributed (families) 11,000 locations People received food packs 50,000 2 As of 05 December 2014. 3 Anti-tetanus vaccination campaign in Guiuan, Eastern Samar was handled by the Guiuan Rural Health Unit medical staff. No data was collected. 03 After almost three months, the medical needs arising from the MEDICAL AND disaster had greatly reduced. Health workers were back at their posts and the main referral hospitals were up and running. In MSF HUMANITARIAN NEEDS facilities, the focus shifted to treating those patients with chronic illnesses and attending to women in need of assistance giving birth. Mental Health Support The Filipino people are used to facing typhoons and have developed a strong social support system and a number of coping mechanisms to deal with disasters. Nevertheless, the severity of this crisis put their resilience to the test. Many of them suffered anxiety and psychological distress as they struggled to cope with loss and bereavement. MSF provided a broad range of mental health support activities as well as MSF was not working in the Philippines when the typhoon struck but mental health care, which it integrated into its medical activities. For its offices in Hong Kong, Tokyo and Sydney regularly monitor disasters examples, group discussions were held with the aim of exploring occurring in the Asia-Pacific region in order to offer emergency community and individual coping mechanisms and promoting peer support. When Typhoon Haiyan made landfall on 8 November 2013, support. One-on-one sessions were also conducted, focusing on those MSF emergency staff were already piecing together information people showing signs of acute distress. People who were suffering being received from the worst affected areas via Filipino field workers, from post-traumatic stress disorder and/or severe depression were relevant government offices and other agencies. treated individually. MSF also turned its attention to children, as the typhoon had made them anxious about being separated from their On 9 November, the first MSF team arrived in Cebu, the nearest city parents, and many had difficulty concentrating at school and were to the centre of the disaster that still had a functioning international either very agitated or quiet and withdrawn. airport. They were closely followed by 300 tonnes of medical supplies and equipment, an inflatable hospital, water and © Julie Remy/MSF sanitation kits, and essential relief items. The devastation wrought by the sheer force of the wind and the water, and the scattered geography of the archipelago, presented those arriving to deliver aid with extreme challenges. There were few functioning airports, the heavily congested ports were ill-equipped to cope with the scale of the aid effort, © Florian Lems/MSF telecommunications were down and transportation links were seriously affected and in some places were completely cut-off. Water and sanitation activities Access to primary and secondary healthcare MSF teams provided clean water, restored and treated water points, carried out waste water management, disposal of medical materials used in health facilities, and constructed latrines. MSF distributed more than 14 million litres of water, supplied clean drinking water to 86,300 people, and distributed water purification tablets equivalent to around 160 million litres of water. Provision of relief items, shelter and reconstruction kits In the first two weeks after the typhoon, many families were either © Florian Lems/MSF living in crowded evacuation centres or in makeshift shelters. Many families wanted to rebuild their homes but were prevented from Most of the local health facilities had been damaged or destroyed doing so by a lack of basic tools and materials such as hammers, by the typhoon, and medical supplies and equipment had been nails, wood, galvanised iron sheets, etc. In response to the needs, washed away or quickly ran out. Patients requiring critical care were MSF distributed 27,500 shelter and reconstruction kits to the most prioritised, evacuated and referred by Filipino health workers to the vulnerable communities to help them return to a semblance of nearest cities with functional hospitals where possible. normality. Nearly 72,000 basic humanitarian relief items such as In close collaboration with the Department of Health (DOH), the hygiene kits, mosquito nets and cooking utensils were also Provincial and Municipal Health Offices and other relevant actors, MSF distributed during the acute emergency phase. rapidly scaled up provision of medical services to restore the capacity of the destroyed local health system. Outbreak prevention (to combat dengue fever, for example) and health promotion were key activities. Mobile clinics were particularly important during the acute phase of the emergency as they were used to reach isolated villages and outlying islands that had had no access to medical services for several weeks. © Laurence Hoenig/MSF 04 Ormoc, Santa Fe and the surrounding areas theatre and the recovery room in Burauen hospital was