November 15, 2013: Dr Johan von Schreeb arrived in the town of Guiuan in eastern Samar Island on November 14 as part of a Doctors Without Borders/Médecins Sans Frontières (MSF) emergency team that is setting up medical services and treating patients in an area nearly totally levelled by Typhoon Haiyan.

The team is creating a system of mobile clinics that can provide outpatient services in Guiuan and also reach more isolated coastal areas and surrounding islands. Additionally, MSF will start providing mental health and water and sanitation services as soon as possible, as well as assist with shelter.

“It Reminds Me Very Much of Haiti”

“The area is about 95 per cent destroyed,” says Dr von Schreeb. “It reminds me very much of Haiti, where I worked after the earthquake, and also Aceh [in Indonesia, where MSF responded to a tsunami in 2010]. But there was no tsunami wave here; the wind was just so strong that it flattened everything.”

With the hospital destroyed, Dr von Schreeb and the MSF team are working at a nearby health centre with Filipino colleagues. There are no surgical facilities, so the team is only able to perform minor surgeries.

Performing Surgeries Amidst Growing Concerns

Much of the treatment provided has involved treating existing wounds that have become infected since the storm ravaged the region last Friday. The team has conducted 25 minor surgeries in the past day and the queues are growing with patients suffering pneumonia and diarrhea.

Tetanus is another concern. “As a precaution we are using tetanus toxoid immunoglobulin,” says Dr. von Schreeb. “It will give patients immediate protection from tetanus. We don’t yet have the set up for cold-chain for the usual vaccines, nor electricity for refrigeration, but it’s coming. Even if we did, those vaccines take a number of weeks to become effective. We do not have time to wait.”

Many of the approximately 45,000 people who lived in the Guiuan fled the area to escape the typhoon, but they are now returning.

“We can see the lines getting longer,” Dr. von Schreeb says. “We are gearing up for their return, and, given the logistical challenges, we’re trying to anticipate what the medical needs are going to be in the coming weeks so we can be prepared.”

Health Staff “Working Around the Clock”

The mental health part of the project also started today, led by a Filipino mental health nurse. Filipino health workers have been instrumental in providing care, according to Dr. von Schreeb.

“The community has done a fantastic job and they have been working around the clock. They are very strong but they are being overwhelmed,” he says.

A priority for the team is therefore preparing a temporary hospital. “It is something where we can really make a difference. We have that experience,” says Dr. von Schreeb.