MSF teams working in China’s quake-hit areas The death toll from the earthquake in southwest China's Sichuan Province has exceeded 19,500, according to Chinese officials. Thousands of people remain trapped under the rubble of collapsed buildings. The epicentre was located in Wenchuan, northwest of Chengdu, capital of Sichuan province. Some 90,000 buildings have reportedly been destroyed and many areas in the mountains have not yet been accessed. Healthcare infrastructure is good in Sichuan, but some hospitals have been damaged and services have been limited. Each healthcare intervention normally costs money to patients, but is free of charge in this post-earthquake period. There is a referral system in place for complicated medical cases, usually from towns to cities. Surgical equipment and capacity are needed, especially orthopaedics (including anaesthesia). Two Médecins Sans Frontières (MSF) teams of three (three doctors, one clinical officer, one logistician, one administrator) have been assessing the immediate health needs in several affected areas of Sichuan. In Anxian, Dujiangyan, and Beichuan districts, north of Chengdu, results from the initial assessment indicate urgent needs for shelters, drinking water, medical and sanitation material. Most pharmacies in the area were destroyed by the quake, and people are facing a dire shortage of medicines. In Beichuan district alone over 5,000 people are reportedly dead and further 10,000 are still missing. Therefore MSF will send drugs, medical material, but also seven inflatable tent hospitals to Chengdu. Another MSF team visited the area of Pengzhou, located about 40 kilometres north of Chengdu. Reportedly, hundreds of injured people in two towns in the neighbouring Longmen mountains were being referred to the local structures. The main reported urgent needs in Pengzhou are for shelters, drugs and medical equipment. In Chengdu itself, the MSF team assessed two hospitals, which had received hundreds of people injured in the earthquake but have good capacity to treat patients. However they urgently need some specific material and equipment. MSF will donate surgical material, perfusions, dressing material, and additional drugs. Material to carry out dialysis will also be donated in order to treat the people suffering from crush syndrome. Crush syndrome is a condition in which muscle tissue damaged by severe internal injury may release massive quantities of toxins into the bloodstream and lead to kidney failure. Left untreated, crush syndrome can be fatal. MSF is also sending three nephrologists to support the treatment of the crush syndrome. “In the assessed areas, a lot of houses have been destroyed and many people have lost their basic living conditions,” says Philip Tavernier, MSF head of mission in China. “We will therefore send blankets, plastic sheeting and hygiene kits (soap, basin, towel, toothpaste, shampoo, etc.) from Hong Kong to the affected area. This material is meant to restore basic living conditions for about 20,000 people.” MSF is also investigating the availability of non-food items in the area such as blankets, jerry cans, plastic sheeting and chlorine for water disinfection. Some mountain roads are still blocked. Many ambulances have been seen transporting patients today — when roads are open. Chengdu airport was reopened today. At some stations, fuel is reserved for relief use. Some roads are also reserved for the relief use only. Supplies are not necessarily readily available in the country (e.g. tents will be difficult to find), and will have to be transported from other provinces or countries. MSF will transport 5,000 tents from Beijing. MSF will continue further assessment, and reinforce its teams on the ground in order to respond rapidly to unmet needs. In the next two days about 25 specialists (nephrologists, surgeons, doctors, nurses, psychologists, logisticians, water and sanitation experts) should arrive in Sichuan, along with additional relief material. MSF has worked in China since 1988. At the time of the earthquake, MSF staff members were working in Nanning, Guangxi Zhuang Autonomous Region where the organization has been running an HIV/AIDS treatment program since 2003. Early 2008, MSF handed over another HIV/AIDS program in Xiangfan, Hubei Province, to the Chinese authorities.