November 22, 2013: At 2:50 am on Wednesday 20 November, a 2.2 kilogram baby boy, Justin James Warren Pambulan, was born in Guiuan on the east coast of Samar island in the Philippines. He was the first baby delivered in MSF makeshift maternity and labour room and his early cries were a final relief for his mother, Sarah. A week and a half earlier, at around the same time in the morning, she was listening to something terrifying.

“It sounded like an explosion. But actually, the sound came from the roof of my aunt’s house where we were seeking shelter. It was raining hard and the strong wind just blew off the roof and then the walls fell down. I covered my stomach with two blankets to protect it from debris. So I moved with my relatives to a bathroom. We thought it would be safe there. But it wasn’t. I was pinned down by a concrete slab on my back and I was very worried for my unborn baby.

“I was praying very hard to survive the danger. I was almost suffocated and breathless because of the heavy concrete. I was trapped in the bathroom for three hours before help came.

“My aunt saved me. She walked me through the ruins. Then I started feeling pain in my tummy. But my aunt told me that maybe it was because I was stressed. Days after the typhoon, last Tuesday, the pain on my back became more frequent and I suddenly felt wet. My waters had broken at midnight. That’s when we went to the hospital.”

Typhoon Haiyan has changed the face of Guiuan’s general hospital. Once receiving patients from five towns, fully equipped with surgical, maternity, and inpatient capacity, it is now in ruin.

But now, temporary tents are set-up in the hospital’s yard, providing inpatient and maternity services, and soon there will be a surgical unit. One of the people working on the project is Greetje Torbeyns, an MSF medical doctor, who has been in Guiuan for three days together with logisticians and other medical staff, to ensure that MSF can scale up its hospitalisation services.

“Setting up the maternity ward was a challenge,” says Dr Torbeyns. “All the maternity facilities were damaged but luckily the beds were still in an acceptable condition. So we had to take them out from the ruins, clean and sanitise them. We also needed a room with clean beds and mattresses for women who try to give birth at home and then suffer from complications such as prolonged labour or eclampsia.  Water is essential too, just to keep everything clean. And then there’s proper waste management to ensure a safe environment, so the disposal of hospital waste is really important.

“So all of this effort then makes the medical work possible,” says Dr Torbeyns. “When this patient came in, it was very dark. There was no light, no electricity. We had to use torches to be able to do our job. It is extremely special to me that I was the doctor of our first mother and baby in the maternity ward. In the aftermath of typhoon, it is very rewarding that we are able to make a difference.”