Typhoon Haiyan: Confronting Logistical Challenges, Reaching More Patients in Need

Almost ten days have passed since Typhoon Haiyan struck the Philippines, and while aid is reaching airports, seaports, and cities, people in many rural areas are still struggling without assistance. Here, Doctors Without Borders/Médecins Sans Frontières (MSF) emergency coordinator Caroline Seguin describes the huge logistical challenges involved with getting emergency aid to where it’s needed most:

In the days since the typhoon hit, we’ve managed to bring more than 150 staff and hundreds of tons of supplies into the country. Now MSF is treating hundreds of patients a day, but the logistical nightmare of getting essential supplies out to the affected areas continues.

Lashing Rain and Blocked Roads

First it was the terrible weather, with rain and strong winds hampering the relief efforts, and roads blocked with debris. Then there was also the problem of bringing staff and supplies in by plane, as the Philippine military was given priority so they could secure airports and cities such as Tacloban, but also evacuate people from the disaster areas.

When commercial and private flights resumed, the airports immediately became congested with the influx of aid. We looked at transport options by water, but this was very slow, sometimes taking 30 or 40 hours to reach the affected areas.

Jammed Airports

It’s primarily to do with the logistical capacity of the small airports in the region affected by the typhoon, and the fact that they simply can’t handle much traffic. They also lack the infrastructure needed for unloading and warehousing the massive amount of cargo that needs to come in.

Of course, it’s not just people and cargo trying to get in; there are also a lot of planes trying to evacuate people from the disaster zone.

Evacuating the Wounded

In the areas where we are working, most severely wounded people have been evacuated over the past week, as well as many who weren’t injured. Those who get evacuated are often the people who can afford it, while those who stay are the most vulnerable.

Fuel Shortage

Fuel is also a major problem. In Guiuan, in the east of Samar island, there is no fuel. We have been using a shared car borrowed from the local council, and we don’t have enough fuel to drive outside the town.

So we are sending a car to Guiuan by plane, while a lifeboat loaded with jerrycans of fuel is on its way there from Cebu. Once we have fuel, we’ll be able to reach the isolated areas along the eastern and southern coasts of Samar, which so far haven’t received assistance.

Local Volunteers Taking on the Lion’s Share

The Filipino people—locals and people from other parts of the country—are doing the lion’s share of the relief work. The work by volunteers has been enormous. It’s amazing—I’ve seen distributions of food, teams of volunteers, drivers, people lending their buildings, cars, boats—and all for free.

People are extremely supportive of our work and of international assistance in general. In Palo, the governor has lent us his car, including fuel, and the department of health has provided the team with accommodation.

A diving company has even lent us a boat to transport our supplies from Cebu to Guiuan.

Taking Shelter in Schools and Stadiums

The situation in Tacloban is catastrophic. Several hospitals have no choice but to do surgery and Caesarean sections without sterilization. There are shortages of drugs, including antibiotics. There are more and more infected wounds. At a health post in Palo, to the south of Tacloban, 70 percent of consultations are for infected wounds. And due to the unhygienic conditions and the lack of access to clean water, diarrhea is on the rise. People are still gathered in schools and in stadiums. The needs are overwhelming.

“No Aid at All” in Some Rural Areas

Right now, the aid effort is quite concentrated on Tacloban, and certainly the needs are huge there. But in places just a few kilometers away, such as Palo, Tanauan, and Tolosa, there is almost no assistance.

In Tolosa, there’s one medical post for a population of 55,000. In Talawan it is even worse—there is nothing. The mayor is looking for a place to set up a camp for 5,800 displaced families who are without shelter, water, or food.

The further you go towards rural areas, the less aid there is, and in some places there is no aid at all. The people have no other choice than sleeping out in the open while heavy rains continue to fall every day.

Immediately following the typhoon there was an influx of organizations of varying sizes and with differing capacity to deliver assistance. Some have very few supplies and will only stay for two to three weeks.

Food and Water Shortages

In many areas, people keep asking about food, and they don’t have enough clean water. To prevent health problems in an emergency situation like this, people need 20 liters of clean water per day for drinking, washing, and cooking. A small plastic bottle of water per day is not enough.

It is still raining a lot, and shelter is a major issue. We plan to distribute tents, but with fuel shortages making transport impossible, it will only happen this week. We will also distribute basic relief items, such as hygiene kits and cooking equipment.

Significant Health Needs

With so many health facilities damaged or destroyed, the health care needs are significant, especially since the living conditions exacerbate the risk of respiratory tract infections, pneumonia, and waterborne diseases.

In most areas where MSF is working—Panay, Guiuan, Ormoc, Tacloban, and Burauen—the health services have been severely disrupted and we’re focusing on restoring quality primary health care and hospital services.

In Guiuan, a tent hospital has been put in place on the premises of the damaged reference hospital, while in Tacloban, an inflatable hospital will be set up this week and will provide all services including emergency room, inpatient department, and operating theater.

At the moment, women with complicated deliveries have nowhere to deliver safely or undergo a Caesarean section, so MSF teams will urgently set up maternity, obstetrics and gynecology units.

In such an apocalyptic situation, the need for mental health services is also overwhelming. All of our teams include mental health officers or psychologists. It’s an extremely important aspect of our response, and quite straightforward to implement compared with other more logistically challenging services.