In the aftermath of Typhoon Haiyan, Médecins Sans Frontières (MSF) has set up an inflatable operation theatre in its tented hospital in Guiuan, Philippines, which is the biggest medical structure in this heavily destroyed region in eastern Samar. Ayron Sanchez, a 10 year old boy, was to become the first child to undergo surgery in the new operation theatre. This is his story.

"When Ayron was a little boy of three years, he fell from a small bridge and his leg got stuck between some wooden planks. Ever since he has had problems with his left leg," says Ruby Sanchez Abendaño, the patient's aunt. She sits outside the inflatable surgery tent and keeps Ayron's father company, a shy man who is nervously waiting for his son to come out. While they wait, the 43 year old woman tells her nephew's story.

"We always thought he would lose his leg"

"We always thought he would lose his leg," she starts. When Ayron turned five years old, his left thigh started to swell. His parents travelled with him to Mindoro, to see an orthopedic doctor. "The doctor advised to amputate. But the parents didn't have enough money for this, so they went back home." After some time, the leg became infected and developed abscesses. Ayron couldn't walk, so his father, a tricycle driver, was carrying the boy on his back. "The child was suffering so much. He was given antiobiotics, but his leg only got worse and worse," recounts his aunt.

"Then typhoon Yolanda came and destroyed our houses." The family sought shelter in a neighbour's house, which was more stable then theirs. "They storm took our livelihoods away. We relied on processing coconuts, but now most of the trees are destroyed. If we plant new palm trees now, it will take ten years until we can harvest them," says  Abendaño.

After the storm, the family, that lives in a small town further up the coast of Samar, brought Ayron to Guiuan to have his leg checked by a MSF doctor. The organisation is working in the district hospital and in rural health centers and offers free medical care, as long as the local health authorities can't cope with the aftermath of the typhoon. Ayron was immediately admitted to the hospital. "The doctor said that he would have to undergo surgery, but that there is no need for an amputation. We were surprised, we had always thought he would lose his leg. We then told the doctor that we have no money, but she said: We don't need your money. We were so happy!"

Good recovery chances

After waiting for three weeks and receiving supplementary therapeutic food to strengthen him, Ayron finally underwent surgery in the operation theatre which MSF has set up on the premises of the Felipe Abrigo Memorial hospital in Guiuan. It is part of the tented hospital that temporarily replaces the health structure, which was fully destroyed by the typhoon. "In total, five municipalities or 110.000 people depended on this hospital before the storm. It had a very good reputation, and parts of it had actually just been renewed," says Anne Khoudiacoff, who coordinates MSF's medical activities in Guiuan. "The next hospital for referrals is in Tacloban, which is three hours by road and has also been devastated. Therefore we decided to set up a temporary hospital in Guiuan. We started with only a few beds, now we have 60 beds and up to 100 admissions per week." The devastated district hospital was the only place in the region offering surgery, so MSF decided to fill this gap by setting up an inflatable surgery tent. "During the first week we have carried out six caesarean sections and seven patients underwent other surgeries," says Khoudiacoff.

Ayron was among these patients: The 10-year-old was the first child to undergo surgery in the new operation theatre. After the operation, Rowena Evangelista, a Filipino surgeon working alongside the MSF team in Guiuan, says he has good chances to recover and will probably be able to walk again. "He suffered from chronic osteomyelitis, which is an infection of the thigh bone. It was probably caused by a viral infection when he was five, rather than his fall from a bridge", she says. "He will still have to stay with us in the hospital for at least six more weeks to recover. Also he has to take antibiotics and we will give him more therapeutic food, to keep him strong." Finally, the patient will have to learn to walk again. According to Dr. Evangelista this is not going to be easy: He will need special shoes, as his left leg is some centimeters longer than his right leg.

Ayron and his family are prepared to take this challenge, says his aunt Ruby Abendaño: "We thought he would lose his leg, but now it has been saved. The typhoon was a desaster, but this hospital is a blessing."