MSF emergency teams are starting to provide medical care in two municipalities east of the coastal city of Pisco, located 185 km south of the Peruvian capital Lima. Over 500 people were killed and up to 2,000 were injured in the 8.0-magnitude earthquake that hit the Peruvian coast on Wednesday August 15. Thousands of people are homeless in and around Pisco, Canete, Chincha, and Ica, which are the most affected zones.

In Pisco itself, where the hospital has been seriously damaged, local medical staff are working hard to take care of the wounded in the city's central park. MSF teams are therefore concentrating their effort on the inland towns of Humay and Independencia, home to 6,000 and 12,000 inhabitants respectively, where health facilities have been destroyed and relief has not arrived yet.

"A 12-ton MSF cargo plane arrived on Sunday with sufficient materials to start providing primary health care, wound dressing, and minor surgery in specifically designed tents," said Luis Encinas, emergency coordinator for MSF in Peru. "We will also organise distributions of hygiene kits, blankets and plastic sheeting for the local population, forced to live in the open with temperatures at night ranging from 6 to 8 degrees Celsius."

Mental health professionals are working closely with the rest of the medical team. First of all, they are working within the primary health structures to help people who have lost all their possessions, and more importantly, their friends and relatives. For that part of the work, MSF psychologists will rely heavily on community groups and networks.

The team will also provide psychological support to people with severe injuries and trauma who are referred to Lima and Pisco. The lesson MSF has learned from other emergencies like the Kashmir earthquake is that this support is critical to help people overcome the double shock of severe injuries and grief following loss and destruction.

MSF is also sending a member of the Renal Disaster Relief Task Force (RDRTF) with specific nephrological materials to treat victims of crush syndrome, a very common condition after earthquakes in which muscle tissue damaged by severe internal injury can release toxins into the bloodstream and lead to kidney failure.

In Pisco, while dead bodies continue to be found by rescuers under the fallen buildings, most of the 16,000 homeless survivors have started to move out of the city to find refuge with or near their relatives. "Many of these areas have received no aid yet, and are lacking water points and medicines," explains Encinas.

While medical work is starting, another MSF team continues to assess the needs in more remote locations where no aid agencies have arrived yet. If more needs are identified in the next few days, MSF might reinforce the team with additional workers and send more relief supplies.

The MSF team currently consists of 12 international volunteers: medical doctors, logisticians, psychologists and a water and sanitation engineer. They work alongside Peruvian colleagues recruited locally.

MSF has worked in Peru since 1985. In Lima, MSF has been running an HIV/Aids project in the slum of Villa El Salvador (near Lima), which is currently being handed over to the Ministry of Health.