While serious logistical difficulties remain, the activities of MSF teams on the islands most affected by typhoon Haiyan are taking shape. With 137 international staff in the Philippines today, and the arrival of 232 tonnes of supplies, MSF teams continue to assess areas outside the main cities while providing immediate medical care in a growing number of locations. MSF is now active on the islands of Samar, Leyte, and Panay, and has most recently started assessing needs on Masbate. More staff are en route and further substantial cargo flights of relief items are also on their way.

Samar

MSF's emergency team in the far east of Samar Island, where the typhoon first struck, has started medical activities in Guiuan town. They performed 600 medical consultations on the first day of medical activities, mostly for infected wounds and lacerations. The MSF staff are working with two Filipino doctors and there are many people from the community who are volunteering to help in whatever way they can.

Half of Guiuan hospital is destroyed and the other half damaged almost beyond repair. For now the medical staff are working among the ruins, but work has started to set up a makeshift tent hospital. Thirty tonnes of material and supplies have reached the team in Guiuan. More cargo planes will be landing in the coming days, among them one with water and sanitation equipment and one with around 1,700 tents to distribute as shelter. More medical supplies will also arrive.

"In Guiuan town, every single roof has been blown off in a town of 45,000 inhabitants," says Dr Natasha Reyes, MSF emergency coordinator in the Philippines. "Half of the city's hospital has been destroyed - no roof, destroyed electricity equipment, etc. It used to be a 50-bed facility with X-Ray, Operating Theatres, everything. The wind destroyed the concrete."

Leyte

In Tacloban city a team of eight is being reinforced with additional staff – medical doctors, nurses, logisticians, a psychologist - to prepare for setting up an inflatable hospital. The site will be located next to Bethany hospital, on the seafront of Tacloban which has been severely damaged by the tidal wave. The plan is to set up comprehensive medical services including an Emergency Room, in-patient department, Operating Theatre, post-operative ward, obstetrics and gynaecology unit, maternity delivery room, psychosocial activities, blood bank, X-Ray, and an isolation ward.

In Palo town, 12 kilometers south of Tacloban, a team of three is organising primary healthcare activities. In and around Ormoc town, teams that include a medical doctor, nurses, logistics specialists and a psychologist started to conduct mobile clinics while assessing further needs. The focus is especially on the evacuation centres where people have gathered following the typhoon. The team has provided some basic medical care.

Two teams conducted assessments along the east and west coasts of the island. Along the west coast there was structural damage in most of the houses, but generally the situation was not as bad as on the east coast, where most of the health structures visited have been damaged and have supply problems.

In Dulang town, with a population of around 48,000, the health facility has been partially destroyed and the medical staff report an increase in patients with diarrhoea. They have also received some wounded people, mainly with cuts. The referral system is not working anymore because there is no fuel to transport patients. The MSF team is planning distributions of relief items and support for the medical facility.

Panay

In the northern part of Iloilo province, and in nearby offshore islands, there is 90% destruction. MSF is planning to focus on the most acute needs including primary medical care through mobile clinics, and distribution of relief items. Needs assessments continue in other parts of the island to identify where MSF’s medical response is most acutely required.

Relief items will arrive in Roxas city and MSF is opening two out-patient departments, in the towns of Cartes and Estancia.

Masbate

MSF has started a needs assessment on Masbate island.