November 20, 2013

“MSF has been doing consultations in the town of Guiuan. Six hundred patients came on the first day. MSF teams on different islands are doing their first consultations, so we are beginning to build a picture of the needs and the human suffering that has accompanied this disaster.The most serious cases we’ve seen in Guiuan are people with injuries caused by the fierce wind. We’ve seen around 60 people needing minor surgery, suturing, cleaning of infected wounds and setting of broken bones. We also saw people with diabetes who have badly infected wounds.MSF’s team in Santa Fe, not far from Tacloban, has seen around 150 people at their clinic, and report the same kind of injuries. There are wounds from nails, from stepping on wreckage. Tetanus vaccination is a top priority. 

A large number of people were indirect victims of the storm, like an older man I saw with a serious lung condition. He wasn’t doing well. He had lost his inhaler, which is dangerous in his condition. We have also seen children who are epileptic and have run out of their medication.There are children with gastro-intestinal infections and diarrhea, almost certainly from drinking dirty water. The wet conditions have aggravated respiratory tract infections. But these illnesses are not yet at alarming levels.MSF’s teams on Panay Island have seen more than 350 patients in their three clinics in and around Estancia, and the pattern is the same there. Our medical teams are on the lookout for dangerous diseases that are endemic in the area – typhoid, schistosomiasis, cholera and leptospirosis. We haven’t yet seen any cases, but the worry is that the conditions might trigger an outbreak.One of our priorities will be to provide maternal and obstetric services. In Guiuan, the MSF team helped deliver their first baby on Monday. Before the typhoon, the town’s hospital saw 10 to 15 births a day.The psychological impact of the disaster is also a focus for our teams. On Panay Island, people are coming to the clinic with physical symptoms that may have a psychological cause: they describe mysterious pains, as well as nightmares and disturbed sleep.We need to get out there and tell everyone that this is a natural reaction. In Guiuan, we started providing mental health consultations for patients and the Filipino medical staff.Many people are too busy to absorb what has happened. I met a woman who had lost her daughter and her mother in the typhoon. She told me about it in a very matter-of-fact way, and said that she cried when it happened but had not cried since. I think many of the effects of the disaster will be delayed. Our teams will be busy for some time.”

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