March 01, 2014


Two days after Typhoon Haiyan hit the Philippines, Ib Younis, an Arizona-based member of MSF’s emergency team, got a call from headquarters; 24 hours later, he was in the country as part of the first wave of MSF’s response. Here he recounts arriving in the affected areas and figuring out where and how to get to work.

I arrived in the Philippines three days after the typhoon hit, met with MSF colleagues in Cebu, and then took a ferry to Ormoc, a town in the northwest of Leyte Island. I traveled with a Filipino nurse who had been working with MSF in Papua New Guinea.

My role was to assess the situation and to give feedback to headquarters so we could deploy the resources needed. Then, I would manage the medical and logistical teams, the relationship with the government, and the strategic direction of the emergency response, including primary and secondary health care, mental health care, water, and sanitation.

I did not expect Ormoc to be damaged because it was not in the projected path of the typhoon. But as soon as we arrived, we saw heavy wind damage, with roofs gone and a lot of wear and tear on the buildings. There was no electricity and the city was in complete darkness. The level of destruction reminded me of Aceh, Indonesia, where I worked with MSF after the 2004 tsunami.

The port and all the hotels were full of people waiting to leave the island by boat. It was hard to find a place to sleep. We went to Ormoc District Hospital, which was badly damaged—the roof was gone. They had to discharge most of their patients and put the rest in the reception area, along with the staff, because it was the only structurally sound part of the building.



Their generators were running out of fuel, so I paid for two or three drums of diesel.

They needed to get their surgery and delivery rooms repaired as soon as possible. I looked at the structure with a flashlight and said we could fix it for them.

They helped us find space in a nearby hotel: two beds, no mattresses, just pieces of wood. As people left the island in the days that followed, other rooms became available. I paid in advance for each one, because we had more people on their way in to help.

Soon afterward, I drove across the island with the director of the hospital to see the provincial administrator in Tacloban. On the way, I assessed the areas along the road and stopped at health centers to make inquiries. Most houses were severely damaged. Many health centers were intact but most of the staff were missing or were looking for relatives.

I asked whether they had wounded people or evacuees from other communities, and if they had cases of infectious diseases such as diarrhea or tetanus. I also asked whether children had received routine vaccinations, such as for measles. I sent this information back to our headquarters so we could deploy more resources.



Back in Ormoc, more MSF personnel were arriving. Congestion at the airport delayed arrival of most of our supplies, but we had kits with basic medical items, so we formed mobile teams to do primary health care and assessments, especially for tetanus.

Our water-and-sanitation team looked at all the evacuation centers in Ormoc district as well. We were concerned about waterborne diseases, and water-and-sanitation systems were malfunctioning because there was no electricity. We positioned generators where they were needed to power water pumps, boosted chlorine levels in the water supply, and closely monitored cases of diarrhea everywhere.

By the second week, our mobile teams were providing primary care and mental health care in about 20 locations in and around Ormoc and Santa Fe, which is close to Tacloban. Our teams saw quite a few neglected wounds, and we provided tetanus vaccinations. We treated common colds, upper respiratory tract infections, and light fevers among children under five. We also conducted a measles vaccination campaign.



Aid was not reaching remote communities, where roads and bridges had washed away, so we used helicopters and boats to access them. Local medical facilities were still in emergency mode, and chronic diseases were going untreated, so we pushed to supply medications for conditions such as diabetes and hypertension.

Shelter remained a problem for many families. In Santa Fe, we gave every household basic items to improve their living conditions, including blankets, mosquito nets, jerry cans, kitchen sets, plastic sheets, hammers, and nails.

Sometimes we found people with broken bones or chronic diseases, and we immediately evacuated them. In the east of the island, we referred patients to MSF’s field hospital in Tacloban. In the west, we referred them to the Ormoc District Hospital. It was damaged, though, so I contacted the Canadian

Red Cross, which worked with the Norwegian Red Cross to build a tent hospital inside. Meanwhile, over the next three weeks, we fixed the roof over the emergency ward and emergency room.

We handed over our programs in northwestern Leyte to the government and other aid agencies in late December. In general, I would say that the Philippine government is prepared for disasters, since they experience typhoons fairly frequently. But they were not prepared for the scale of this disaster. Our role was to make sure that the medical infrastructure was still running. We filled the gap as much as possible.

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