Reported by AITOR ZABALGOGEAZKOA, in Tegucigalpa, Honduras, November 11, 1998
A Doctors Without Borders/Médecins Sans Frontières (MSF) physician and Jose Lopez, a French water and sanitation engineer, were the first outside emergency personnel to arrive in Yoro in the northern part of the country by helicopter six days ago. The Yoro region, with a population of 32,000, is made up of 96 small communities which have been isolated from the rest of the country due to the destruction of 30 kilometers of road. Twenty-five of the 96 communities were completely cut off from the main population and little news has been heard from them. By flying over the area, MSF could see that the road to these villages had been completely washed away and access could only be via helicopter.
When the MSF team arrived, they found the local population very well organized, but in complete shock. They had no electricity and no water. There was very little fuel left for cooking and the main hospital was trying to cope without adequate fuel, electricity, adequate food, water and medical supplies. The hospital was close to running out of fuel, medicine, and water when the MSF team arrived. The team did their best to help the 25 patients who had been injured during the flooding by rocks and trees and debris as the river rushed through the area. Without electricity, the medical staff could not even perform simple, routine operations. One small boy, for example, had a coin lodged in his throat, and without electricity or medicine, he could not be operated on.
The local health and emergency personnel of the Yoro region have been very cooperative. MSF is helping them restore the roads and the water system. An MSF team has returned to the region with a truck from Tegucigalpa and a 3-person team in Land Cruisers. MSF will bring water, fuel, medicines and medical supplies for the hospital and the rural health centers as well as water tanks for the rural communities and pipes to repair the water system.
Jose Garcia, a French water/sanitation specialist, Sylvie Pouit, a French nurse, and several other MSF personnel reached the Choluteca region by car five days ago. Until the middle of last week, nobody had realized that the southern part of the country had been hit so strongly by the hurricane. Previously, most of the relief efforts had been concentrated in the north. The Honduran and Mexican military had flown over the area by helicopter and told MSF to go there when they saw how many people were still on rooftops. MSF was the first outside relief team to cross the semi-rehabilitated road between Tegucigalpa and Choluteca, a region on the delta of the Choluteca River. This fertile land has many watermelon, banana, and sugar cane plantations. Its proximity to the Choluteca River worsened the damage caused by the hurricane when the river flooded. People were stranded on rooftops and in trees for eight days. When MSF arrived, Choluteca was still partially flooded, as were other surrounding rural communities. An initial assessment found 150 dead and 2,500 missing.
In Marcovia, a rural municipalty of 40,000 people, 20 km west of Choluteca, the flood waters rose to 2-3 meters above the soil. The region was flooded for seven days. One group of 36 people from different families remained stranded on a rooftop for even longer because there was a tree so close to the house that helicopters could not reach them or give them any food. Finally, the helicopters helped to string ropes from one rooftop to a school nearby. The people began straddling the ropes and sliding along them to the school where they could be rescued. Stronger people tried to help the children and pregnant women make their way across the river. Nevertheless, 3 children lost their hold on the ropes and were washed away by the flood waters.
There is an insecticide factory in Choluteca where 50 large containers of chemicals were stored. The flooding destroyed the factory and washed the containers downriver and into the sea. The containers held insecticides, including pure chlorine, methane, and other toxic chemicals, that pose a terrible contamination risk. These containers were floating in the river and some were responsible for killing people on top of the roofs. One of the groups on the rooftops had watched helplessly as a 15-meter long container struck and killed 6 people on a rooftop nearby.
When MSF arrived, the water had just receded. The houses were filled with 2 meters of mud. At the latest assessment, of the half-million living in the region, half of them were affected, with 241 dead, 253 injured, and 2500 missing. Three thousand houses were destroyed, and 14,000 were damaged. In the entire region, 300 communities are cut off; of 160 health centers, 64 were damaged or destroyed. MSF returned the next day with a convoy of 4 Land Cruisers carrying a 15,000-liter water tank, a Zodiac boat, and a water chlorination system to support the regional health departments. French MSF water/sanitation specialist, Gilles Sellier, who is also an experienced diver from the French army, went with local firefighters in the Zodiac to show them how to identify the chemical containers and remove them safely from the water. MSF then donated the boat to the firefighters who are continuing to remove the chemical containers.
Jose Garcia has been to more than 50 countries and witnessed the aftermath of many disasters but he was shocked when he arrived in Choluteca. So when Jose announced, "This is really a serious situation," his MSF colleagues knew that he really meant it. Particularly, when he saw what was left of what the local people said was once a 300-meter long bridge over the Choluteca river. It had been completely washed away. Jose, Sylvie, and the rest of the MSF team found that the local health and rescue authorities had a superb attitude and were very happy to coordinate with the team to continue rescue and cleanup operations.
Locals told Jose that after 4 or 5 days of being on the rooftops, they felt that the water would never go down and that the entire world had been flooded. "How are we going to make a life here with all of this water?" they asked. "The water never stopped coming. And we had the feeling that nobody will ever come."
Wilfredo Hernandez Paz, the mayor of Marcovia, was also involved. He lost everything, including his home. When Marcovia got the Hurricane warning at 8 pm, he and others rushed to warn all the communities nearby, but they didn't have time to reach everywhere. By 11 pm the water was at the maximum level. Wilfredo himself was isolated on the only bridge above the waterline for many hours.
There are 34 dead in Marcovia and nearly 450 people still missing. The stench of decaying human and animal carcasses permeates the air. The bodies that they are finding as the water recedes are not from Marcovia, but from communities further upriver. The bodies are stripped naked and battered and are nearly unidentifiable. Marcovian health officials are burning and burying the bodies they find.
An MSF team including a doctor, a nurse, a water sanitation specialist and a logistician arrived a few days ago. MSF went in with two Land Cruisers and yesterday also delivered an additional cargo containing an emergency health kit, some medical kits for the rural health centers, and food and water.
Reported by PETER THESIN, Managua, Nicaragua, November 10, 1998
Posoltega is a small town near the volcano where the mudslide occurred following Hurricane Mitch. There are approximately 4,000 refugees isolated on the sides of the volcano. They have no food, no water, no shelter. MSF teams arrived here Sunday, joined by Edwin, a 25-year-old Nicaraguan doctor trained by MSF. The team found 50 people who had lost everything. They sit on the side of the volcano where their village once stood. More than 20 children are suffering from pneumonia and exposure. One woman, Gabriella, held a newborn baby, red and feverish with pneumonia, in her arms. Her husband, her home, and the village of her birth are buried under the mud where she sits. She tells Edwin that she gave birth to the baby on the slopes of the volcano just two days earlier. Edwin administers penicillin to the baby, while other MSF team members provide the refugees with food, milk, and water. When Edwin tries to persuade Gabriella to go down the volcano and get care for the baby, she refuses. "I am afraid to leave," she says, "I want to stay where I was born."
A 45-year-old man from Posoltega tells of sitting by his home on the side of the volcano at 1:00 in the afternoon on the day of the mudslide, when suddenly the ground moved and his house and cattle slid away down the slopes before his eyes. As he watched, he thought that the gods were intervening. "I have lived here on the volcano my whole life," he says, "It is the risk I took."
MSF is returning to Posoltega and providing medical consultations. To reach Posoltega, the MSF team travels by Land Cruiser through a valley 24 km long and 50 meters deep that was created by the mudslide. Dead cattle lie decaying by the sides of the road; the stench is terrible. It takes 4 hours to travel 200 km from Managua. Posoltega is in one of the hottest regions of the country. Temperatures are in the 30 degrees Celsius.
Reported by OSCAR BERNAL, Nutritionist/Public Health Professional, Guatemala City, Guatemala. Oscar Bernal has been working in Guatemala for four months and, in the wake of Hurricane Mitch, has been assisting in the emergency relief effort.
On Monday, November 2, we went to Chinoc Izabal near the Atlantic Ocean. We went to the banana farms in Izabal in our helicopter. We had planned to land, but the area was still covered with water and we couldn't. It looked like an ocean. You couldn't even see the houses. You saw only water and a few roofs. Finally we found one airport where it was possible to land and there were 800-1,000 people gathered there. All of their homes and farms had been destroyed-not only the houses but all the buildings were completely under water. It was terrible to see from the helicopter. An area of 10-20 km between Guatemala and Honduras was one of the most affected. We spent two days doing medical consultations and installing a water pumping system to be sure that people had clean drinking water. But then we had to leave because the floodwaters were rising again. This area had to be evacuated within a few hours or we all would have been under water. We only had time to give some emergency first aid to those with broken bones, and then evacuate them. A helicopter was organized by the Mexican army and we helped evacuate people to elsewhere in Puerto Barrios, Guatemala.
Some people had broken bones or skin problems, respiratory infections, and diarrhea. People had nothing to wear, nothing to eat. Everything was left in the houses; they had no time to leave.
I remember one family. The child was only 4 months old, but the mother wasn't breastfeeding because she was sick. The milk and everything had stayed in the farm. We tried to find milk, but it wasn't possible. When we got to Puerto Barrios, we finally found milk for this child. Before the evacuation people waited 2-3 days in the airport-the only place that was dry. The child was very, very sick. He was dehydrated. We arrived after 4 hours in Puerto Barrios. After 2 days I saw the child again and he was much better.
Then we arrived in Puerto Barrios and tried to go to more isolated areas. We went to one called Los Amates. In this area we helped in the health center. We sent a 15,000-liter water tank and a chlorination system and give medicines to the health centers. Then, we went to other areas that were more isolated, and there we gave medical consultation to the displaced people, and donated another water tank. In three days we provided 3 water tanks and 420 medical consultations.
People in Puerto Barrios have lost their families and their homes; their lives are completely destroyed. People need a lot. Even when the floodwater arrived at their houses they didn't want to leave because they would lose everything in their houses. People didn't even leave when the water was rising. They only left when it was impossible to stay.
The people who died drowned. CONRED, the coordinating emergency work, has started removing bodies. There are human bodies and cows that died in this area. The second problem is that organophosphates, chemicals used in farming, went into the rivers-50,000 tons. So people can't drink the water. The wells were contaminated. Therefore, MSF is transporting the water from safer places and is involved in efforts to rebuild the water systems.
MSF is sending more personnel and materials. We now have an Emergency Team with 45 persons in Guatemala. Our team is working in 3 areas: Isabel Departimento, Izabal Dept., and Guatemala City. This is a very large area, and we're not only in the capitals but in the isolated areas. On Sunday we received 18 tons of medicines and supplies and our teams are out distributing it right now.
Now we have a lot of cholera in Izabal and some in the Guatemala City capital. The number of cases is increasing quite fast. Cholera has been in Guatemala since 1991, but this year the number of cases has increased fast. Long before the hurricane hit, MSF was already actively working to treat those infecte and stem further outbreaks. In the last week there were 67 cases in Guatemala City, 53 cases in Totocapan, and 53 cases in Izabal.
The teams' priorities in the aftermath of Hurricane Mitch are: 1. Guarantee water for people, and it needs to be chlorinated. 2. To help us help the health centers & give medical consultation in isolated areas. 3. To reduce the risk of cholera and treat cases of cholera. 4. To reduce risk of other problems like malaria, dengue, and others.
Something that has really impressed me is the solidarity from the community-the farmers, the administrators of farms. They have lost everything and have no possibility to rebuild their houses or replace their things.
For me the main problem is not today. The main problem will be in 2 or 3 months. Right now they're receiving quite a lot of help and food. There's a lot of solidarity. But in 1 month, no one will remember Guatemala. The people will return to their farms, but all the plantations will be destroyed. I'm afraid for nutritional problems in 2 months. Another area is in mental health; Post-traumatic stress will be a big problem.