Philippines: indecent comparisons

MSF Philippines Haiyan typhoon emergency response

Yann Libessart, MSF emergency team

Too many journalists are asking us to compare Typhoon Yolanda [as it’s known locally] and the 2010 earthquake in Haiti. Many of us here were in Port-au-Prince in 2010 and we all agree: the two disasters have nothing in common, and any comparison would be indecent.

Already, before 12 January 2010, Haiti faced many disadvantages: poor public services, political instability, urban crime and widespread poverty. The earthquake hit a state that was already in the midst of a humanitarian crisis. MSF teams had been working on the ground for years and were able to start operating straight away.

Before 8 November 2013, the Visayan archipelago was a touristy destination, popular with divers, backpackers, eco-friendly tourists, honeymooners and sexual predators (though I wish we didn’t have to mention those). The Filipino state emergency response agencies worked almost full-time for years, moving from typhoon to earthquake to volcanic eruption. While it took MSF almost a week to get there, the agencies’ response mechanisms were set in motion instantly.

Many survivors say they hadn’t anticipated the sudden increase in water level because English-speaking media spoke about a ’storm surge’ and never used the term ’tsunami’. I also didn’t immediately understand what this ’storm surge’ referred to. As a result, the most educated people evacuated the area, whereas others thought they would just be facing violent storms, something they are used to.

A terrible rumor illustrates how the Filipinos learnt the hard way what the term ’storm surge’ meant. Being long familiar with typhoons, the government is said to have deployed 200 policemen on the ground in order to reestablish order as soon as possible and to limit looting. As a result, 200 policemen drowned. I wasn’t able to verify the information, but I have seen images of floating bodies wearing T-shirts with the legend ‘PULIS’. If you want to sound the alarm and save lives, make sure you’re going to be understood. When people hear ’tsunami’, they start running. When they hear ’storm surge’, at best they look for a dictionary. Which is what I did.

Devastation in Tacloban © Yan Libessart/MSF

The priority for survivors is to get back to normal life – or at least to be self-sufficient again. The majority of the most vulnerable people were able to leave the devastated area thanks to mass evacuations coordinated by the army. Conversely, thousands of Filipinos came spontaneously from all over the archipelago and from overseas in order to help their families, their friends and their fellow citizens. More than 30,000 Filipino aid workers are involved in the ongoing response.

Two weeks on, the drowned of Tacloban have almost all been buried. Streets are usable and busy. People visit food distribution centres as if they were on a shopping trip, selecting only what they need. The water system is functioning again – whereas it still doesn’t in Port-au-Prince, where cholera still has devastating effects. Shops have re-opened. ATMs spit out cash. Prostitution is back.

In the meantime, more than two weeks after the tsunami/storm surge, hundreds of NGOs keep meeting every night at 6 pm in their crisis centre in order to decide who is going to do what, under the half-amused, half-sleepy eye of a government representative. This morning, while an NGO was trying to draw attention to its distribution, Tacloban’s inhabitants were passionately watching their national hero Manny Pacquiáo’s boxing game on the big screens installed in the streets.

Filipinos watch national hero Manny Pacquiáo on screens along the street. © Yann Libessart/MSF

But stay cautious. Even though the risks of measles, polio, cholera epidemics and malnutrition – much talked about during the 6 pm meetings – are likely to be minimal, the devastation has created new health hazards that MSF is doing its best to warn against in the midst of all the noise.

When the first MSF team arrived in Tacloban six days after the tsunami/storm surge, we were sleeping on the floor of a garage. I remember being pleasantly surprised by the absence of mosquitoes during this Spartan night. The mosquitoes who couldn’t be evacuated by the government were probably wandering around somewhere between India and Saudi Arabia.

The anopheles mosquito needs only a couple days to reproduce, providing the water is not salty. The tsunami/storm surge left behind brackish floods, impractical for breeding mosquitoes, however horny. But it has rained every day since, and the pH of the ponds is now suitable for ‘insect-making‘ intercourse. Mosquitoes are thus back en masse and abstinence has made them hungry and angry.

The risks of dengue fever, chikungunya and malaria are serious for all those living in the open, or in houses with smashed windows. Filipino people need to be able to protect themselves with prophylactic treatments, sprays and mosquito nets. Yet today, tens of thousands of blankets are being distributed throughout the archipelago by various organisations of every flavour. Why? Because… winter is coming?

Along the same line, rats are everywhere and represent a health hazard as carriers of infectious diseases such as leptospirosis. But Filipinos are well aware of this risk and know how to protect themselves without condescending lectures on hygiene.

Humanitarian emergency relief response to disasters is above all else the science of improvisation. Never mind the obvious oxymoron (which is to contradiction what ‘storm surge’ is to ‘tsunami’), improvisation requires preparation. People expect a large international humanitarian machine to be set in motion. They do not expect, however, that this machine will not be able to adjust to the situation and will hold back when it becomes obvious that supply will exceed demand.

The site of Bethany Hospital before the cleaning up. © Yann Libessart/MSF

 

In the end, our biggest fear is road accidents, given the potential severity of the injuries and the few hospitals equipped to handle them. A lot of vehicles were lost in the tsunami/storm surge, and the rare means of transport today are monopolised by NGOs. Having five people on a single motorbike without wearing helmets drastically increases the risk of serious accidents, particularly when riding on wet, slippery roads. Since the major roads were cleared, sparkling new air-conditioned four-wheel-drives seem to be recreating an episode of the series ER by driving down them at full speed – an incredibly dangerous game given the number of people currently camping on the verges. A team of cops equipped with cameras and speeding tickets would probably save more lives than these road hogs.

Another hazard is the risk of fires and serious domestic burns. Left without electricity, people use candlelight and cook on small gas stoves or braziers on the ground. The wet season is not only a blessing for hungry mosquitoes, it also stops fires spreading. Conversely, the catastrophe in Haiti took place at the beginning of the dry season, when the sun stuns the whole of the Caribbean islands. More than three years afterwards, caring and nursing for badly burnt people is still one of the main activities of MSF in Port-au-Prince…

For the first few days after the disaster, night-time silence entirely filled the sleeping city. No more electricity. No more cars. People were exhausted. For months in Haiti, the sound of silence was troubled by shouts, cries, chilling screams, gunshots. Yesterday night in Tacloban, from the fifth floor of our MSF hotel overlooking the city, I could hear a couple making love…

Clearing yet another office on the ground floor of what used to be the administration building of Bethany Hospital, I stumble across a box of pills to treat erectile disorder, which of course I give to the medical coordinator in case someone really needs it. It’s actually an option in the treatment of temporary depression, common after such a tragic event. From now on, whenever I hear frisky lovemaking through the Filipino night, I won’t help but think about my modest contribution to this prompt return to normality, for which Filipinos should be congratulated.

Setting up the inflatable hospital at Bethany Hospital, tacloban. © Yann Libessart/MSF

The impressive speed at which the people of Tacloban are taking back ownership of their city could limit our response to a short period, perhaps a few weeks. MSF has approximately 30 international staff in Tacloban, but this number should decrease rapidly. The hospital has now been set up and Filipino medical staff are coming back en masse to resume their work.

One of the hospital doctors came to visit me two hours after I had finally managed to set up my ‘office’. I was covered in sweat and all of my muscles ached. “I am the director of this hospital and you are in my office,” he said, with a stern look on his face. Ouch. I have a feeling I am going to be clearing myself another space very soon. If I find another box of the blue pills, this time I’ll leave them there so as not to anger their owner.

Beyond physical space, medical cohabitation between a humanitarian organisation and a private hospital can very quickly become complicated. Skillswise, Bethany hospital’s former staff will soon be able to provide all the care needed. However, in terms of free care, at least for the poorest, MSF is going to need some guarantees before we leave. Our patients don’t pay anything. It’s a non-negotiable aspect of MSF’s work.

One last symbol : the first programmed surgery in the hospital was not the amputation of an infected limb but a caesarean section. Yolanda if it’s a girl, Haiyan (or storm surge) if it’s a boy?

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23 Responses to Philippines: indecent comparisons

  1. amar says:

    Bless you & your colleagues at MSF, Yann :)

  2. faye mcBnoiar says:

    Great piece!
    Thank you for sharing your observation and how beautifully written. You just made me wander with you in Tacloban which was really enjoyable!

  3. Geri Rhodes says:

    I’m also from Leyte and currently residing here in the UK.
    I thank you for your kindness and help to our people in Leyte.
    My family had used Bethany Hospital from birth (I was born there) to treatment and even death of my mum and brother. I’m sadden that the free medical, first class and humanely treatment to patient will now be over. Local doctors at the Bethany charges a lot and won’t treat if you have no money to show or won’t release the patient/dead patient if bills are not fully paid. Patients were treated differently depending on its social status and wealth but I hope it will change. I hope when the international humanitarian/medical team leaves, Bethany will not start charging the patients on all the medicines left by the international medics and surgeons and not double up their consultation or service fee. People in Leyte have just started to recover and money is not easy to find both by the local and their relatives working abroad. Hope the private doctors won’t bleed the victims of Yolanda. God bless you and your team for helping our people without asking anything in return. I salute you!

  4. Sarah Jane says:

    thank you Yann Libessart for this witty and candid blog… and to MSF emergency team for your quick and immeasurable response…

  5. Maybelle C. Flores says:

    Thank you so very much Mr. Libessart. MSF and countless other such organizations have rendered the Filipino nation the help we need so much. Mabuhay kayo! Mabuhay ang Pilipinas!

  6. Rio Noyce says:

    Dear Yann,
    I truly appreciate your blog and enjoyed your candid and humorous observations. I am sure you and your MSF group were overwhelmed with the work you faced ; humor and laughter is good medicine for sure. I almost fell off my chair and wet my pants laughing at your unexpected funny remarks.
    I am an RN living in California. I am from Zamboanga City in the southern part of Mindanao, where I graduated from Zamboanga General Hospital School of Nursing many moons ago. My family had just endured a horrendous war by the Muslim National Liberation Front (MNLF) rebels wanting to take over our city, taking hostages and setting fire to a few villages. My sister said, she thought something like this only happened in the Middle East. The war lasted for almost a month, then came the torrential rain which caused widespread flooding and landslides adding insult to injury. Many lives lost. Not too long after, the earthquake in Bohol shattered the Island. My family survived all these calamities, barely.
    I was glued to the internet during the war in Zamboanga listening to Ustream radio as I was in Electric City, Washington (ironically we had no TV.) besides, the media did not cover the war..it was not politically correct, I suppose. I came back to Taft, California before the typhoon hit, so I was glued to the TV. Felt helpless especially with CNN’s Anderson Cooper’s coverage . There were more insults and embarrassing commentaries , that I felt , did not help uplift the morals of the poor people that survived. Though it did raise awareness to the dire need of the Philippines, especially Tacloban, Leyte.
    This is my first time to come across your Website, thanks to my brother-in-law in Florida who is a doctor and has connections with friends in the same field , volunteers. I wish I could go and volunteer. But, I’m afraid I would just be a hindrance given my age and frailties. Your descriptions is really appreciated. Even enjoyed your mosquito breeding lesson!
    My brother-in-law’s friend mentioned that life is starting to return to almost normal, even prostitution is back!!! That is quite disconcerting, though..considering poor hygiene conditions. I hope your blue pills did not contribute to some frisky behaviors!=))
    You just don’t know how grateful we all are for your grand deeds…you all have earned your wings!!! God is grateful to have you as His angels. I hope I have not offended you with religion…
    Please feel free to share my email with your fellow MSF’s. We will forever be a grateful nation. And, I will definitely share this site to all the Filipinos living abroad. Thank you!!!
    Rio

  7. MISUNDERSTANDING THE ALIEN WORD “storm surge”
    Me, as an aborigine or lumad in the Southern Philippines, I need to cling from a very limited time to meet my uncle at least 1 day each year and to learn the Subanon Language which is the language of my tribe. I am also an alien of my tribe because I am Subanon but I could not speak Subanon language. My mother tried to hide the fact that she is a native and a subanon woman from the Visayan migrants living in the Subanon territory because of fear from existing racial discrimination. My mother just wants to protect us from harm so she hides from the community that we are Subanon race and taught us only English and Visayan languages since birth.

    Visayan language now could be my considered mother tongue, Subanon language my desired language to learn, Filipino language which mistakenly patterned to tagalog is another burden to learn even the fact that 2/3 of the Philippine population speaks Bisayan (Visayas and Mindanao) Filipino still patterned to tagalog as it is the language of the Capital Manila. Yet another challenge is to learn how to Speak English for the many.

    Since in the Philippines; English and Filipino are the official languages, so I give more focus to learn English than tagalog because if I could learn English, the world could understand me but if I could master tagalog, only Manila could understand me but I didn’t dream to live Manila, I don’t want to join the pool of the crowd that would or might stay in the shanty town if I could not land a better job. I was once there in Manila but I suffered discrimination in searching for job, I would be the last priority because I came from the south. I recalled the “Sun Cellular Company” did it, the supposed to be first day of my work was cancelled after the Vice president of that cellular company learned that I am originally from the south (Mindanao).

    So my point here is the problems are so complicated, racial discrimination to many tribal people, so many language to learn and many things name it….

    I am a graduate of Bachelor of Science in Accountancy (BSA) and have my Masters in Business Administration (MBA). Reason why I started coming out from my Subanon Tribe origin is because the Philippine Educational standard required supposed to be to all citizen is to have Master’s degree and I have it so I believe that the discrimination for a native and aborigine person like me would be lessen but I am totally wrong because I could not find job easily in the country. The good thing is I got an offer from the other country so I landed a better job in a top 50 of fortune 100 companies where I am working now.

    Well, that alien word I mentioned above is about the “storm surge”. I am a fairly educated person, I am confident and I believe it. I have my MBA but such term is still something new to me. My education is more focus on debit and credit, or money and not about storms, typhoon which are not interesting story for any business. In spite of so many languages I need to learn in the Philippines in order for me to be ‘belong” to any community; I could still understand that term ‘storm” and “surge” but I could not figure out how would it look like, I didn’t think that it is as worst as tsunami because it is not common in the Philippines. For the citizens, storm surge is just a theory but tsunami is a feared tragedy. It didn’t commonly happen in the country. Yes it is very clear word “Surge” or something will rise up like water, but the common understanding of the people didn’t associate with flood like or tsunami like but just “big waves in the sea” what would surge are the big waves from small wave to bigger and bigger just in the sea not to the land.

    In local terms, there is no equivalent term for “storm surge” because it didn’t happen before for the aborigines to name it. What we have is just for flood as an ordinary overflowing water name as “Baha” for extra ordinary and huge flood then a term “Lunop” or Earthquake as “Linog” but the north of the country have other terms for that also but they don’t have “Storm surge” equivalent than just to adopt that alien term.

    My comment is about exaggerating but I just tried to share how language is a trouble in the country, what makes the storm surge misunderstood and etc. Thanks for the great article.

  8. Ricky Tikyo says:

    Thank you very very much MSF! I enjoyed your journal very much as well hahahaha Again, Thank you very very much :)

  9. GMC says:

    I like the candidness of the write-up.

  10. koala says:

    Love the way you wrote your piece. Entertaining with a punch.

    I don’t understand why people tend to be too technical just to look intellectual. Isn’t it better if more people understand the
    the message? rather than the people dismissing it and not giving a care at all. More people listen if they grasp and understand what they hear just like the storm surge vs tsunami. They may be technically different but have the same deadly effect.

  11. Gene Amparo says:

    Excellent article. I’m so glad someone who is actually in Tacloban filed a positive report about the Philippines and Filipinos; with a marvelous sense of humor at that. I admire your dedication and selflessness; you were in Haiti and now in Leyte. I once looked into MSF but realized I would be useless as a radiologist. While I enjoy the comfort of life in California, you are saving the lives of my countrymen in the island where I was born, Leyte. In fact my 95-yr-old mother was one of the very lucky ones because she was on the last flight from Tacloban to Manila before the typhoon canceled all flights. It was a trip she had planned months before.

  12. Rayamel Tongol says:

    Hi Yann, Thank you so much for the help you have given for the people of Tacloban, people like you are needed around the globe. Again, Thank You Very Much.

  13. H. Suson says:

    The Tacloban mayor was relaxing in his beach house when the storm came.

    He himself did not understand what was coming.

  14. Aye P Ubaldo says:

    “When people hear ’tsunami’, they start running. When they hear ’storm surge’, at best they look for a dictionary. Which is what I did.”

    This reminds me of a post a friend of mine read wherein the question was asked: Why do we give cute names to storms? Haiyan, that’s a cute name. Yolanda.. charming. If it is a killer storm, give them names like Storm Death Megatron 3000! — No need for any dictionary there.

  15. Pingback: First hand accounts of MSF, or Doctors without Borders, emergency response in the Philippines | Philip Lorenzo

  16. Antonio Pavia Jr says:

    Thank you Po. Blessings be to you and your loved ones!

  17. Atty. Jeannette M. Dacpano says:

    The Filipino people are very thankful for everything you have done for us. We could not thank you enough for your empathy. Mabuhay po kayo!

  18. Loreto Quevedo Dimaandal says:

    Mabuhay and thank you very much to you, Mr. Libessart, to MSF and to everyone and every country and all NGO’s/NPO’s who helped and are helping our kababayans!

  19. Dear Mr. Libessart,

    I am Patricia Aquino, a reporter for Philippine news site http://www.interaksyon.com. May we have permission to repost this on our site? Please let me know through e-mail.

    Thank you very much.

  20. Nadine says:

    Hi Yann, (or should I say Haiyan?) ugh, sorry, I couldn’t resist.

    Thank you for your article. I’m sure you’ve read the reactions, both negative and positive, to the response to the disaster, and from my perspective, it was somewhat disheartening because at a time when Filipinos should be coming together, I felt it created more divisiveness. But your article, very funny, by the way, described how the people were coping and picking themselves up from the disaster. Also, your first hand experience in Haiti gave a much needed perspective to the disaster and that no, Tacloban/Central Philippines cannot be compared to Haiti.

    Thanks a lot to you and your team at MSF for providing much needed help. The Filipino people are forever grateful to you and your team. Maraming-maraming salamat sa inyo, mabuhay kayo!

  21. Elso Cabangon says:

    Maraming maraming salamat Mr Yann. Your and MSF help is very much appreciated. God bless you and your team!.

  22. Val (Bim) Dolorico says:

    I am from Tacloban currently residing in Florida. Thank you for all the help you have given to the people of Tacloban. I like your style of humor in the midst of all the devastation. I grew up in the campus of Bethany, formerly a Presbyterian mission hospital, of which my father was the director for 50 years. The Filipinos are resilient and will recover but they will need a lot of help.
    Madamo nga salamat ha inyo.

  23. marcelo estrada says:

    Thank you so much, MSF. I love and support the work that you great. Great writing. Like the part about the tsunami/storm-surge.

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