Dr Johan von Schreeb arrived in Guiuan in the east of Samar island yesterday, an area devastated by Typhoon Haiyan and where Médecins Sans Frontières (MSF) emergency team is setting up its medical services and treating patients. They are creating what will be an integrated provision of mobile clinics, reaching out to the more isolated parts of the coast and islands, and outpatient services in the town of Guiuan itself. Guiuan had almost all of its buildings destroyed and the local hospital is not functioning. MSF will be providing water and sanitation services as soon as possible and will also assist with shelter.

“The area is about 95 per cent destroyed,” Dr von Schreeb said. “It reminds me very much of Haiti, where I worked after the earthquake, and also Aceh. But there was no tsunami wave here; the wind was just so strong that it flattened everything.”

With the hospital destroyed, Dr von Schreeb and the MSF team are working at a nearby health centre with Filipino colleagues. There are no surgical facilities so they can only do minor surgery.

Twenty five minor surgeries performed

Much of that treatment has involved treating existing wounds which have become infected since Typhoon Haiyan hit the region last Friday. There have been 25 minor surgeries done in the past day and the queues are growing with patients suffering pneumonia and diarrhoea.

Much of the local population of around 45,000 chose to flee the oncoming typhoon, but they are now returning. “We can see the lines getting longer,” Dr von Schreeb said. “We are gearing up for their return and given the logistical challenges, we’re trying to anticipate what the medical needs are going to be in the coming weeks so we can be prepared.”

Temporary hospital

A priority for the team is therefore preparing a temporary hospital. “It is something where we can really make a difference. We have that experience,” Dr von Schreeb said.

The other concern is tetanus. “As a precaution we are using Tetanus Toxoid immunoglobulin. It will give patients immediate protection from tetanus. We don’t yet have the set up for cold-chain for the usual vaccines, nor electricity for refrigeration, but it’s coming. Even if we did, those vaccines take a number of weeks to become effective. We do not have time to wait.”

The mental health part of the project also started today, led by a Filipino mental health nurse. This reliance on the Filipino health workers has been the strength of the activities, according to Dr von Schreeb. “The community has done a fantastic job and they have been working around the clock. They are very strong but they are being overwhelmed,” he said.