Fieldset
Stripped and bare

The first thing you notice as the ferry comes into port is the trees have no leaves. In fact they barely have branches. It’s an eerie scene. Then you notice half the buildings don’t have roofs.

The first thing you notice as the ferry comes into port is the trees have no leaves. In fact they barely have branches. It’s an eerie scene. Then you notice half the buildings don’t have roofs. Typhoon Haiyan (known locally as Typhoon Yolanda) indiscriminately stripped anything that wasn’t solidly attached! But then as we’re unceremoniously deposited on the jetty and dozens of porters descend on our luggage you notice the busy streets, the colourful autorickshaws and the bustling markets. The streets are alive with activity. This is not a city in despair but rather a city full of resilient people, dusting themselves off and getting on with the business of survival.

I’ve arrived in Ormoc City on the island of Leyte, one of the worst-hit islands. The streets are lined with rubble, mangled cables and collapsed lampposts. Even our hotel did not escape the damage. The roof was almost completely ripped off. From a distance it looks inhabitable. But it’s business as usual on the floors below. There’s almost no power and limited water but the rooms are clean and the cook rustles up delicious meals of seaweed, local seafood and tropical vegetables.

Our team, made up of doctors, nurses, logisticians and a mental health officer is already carrying out mobile clinics, heading in a different direction every day, trying to reach the people in need.

My role is to set up surveillance, an early warning system for the diseases we might expect following a typhoon such as leptospirosis, tetanus, cholera, measles and dengue. The earlier we know of such cases, the quicker we can respond and the more likely we can avert an outbreak. So I need to find out whether a surveillance system has already been set up or whether I need to start from scratch.

I head down to the city hall, the operations centre for disaster relief. There are tables set up representing different government departments. I meet Dawn, an American woman formerly in the Marines and now working in disaster management. Within days she has got to know the key people in the city. She tells me that there are food distribution problems (reports of people not receiving food despite deliveries being made), all of SE Asia seems to have sold out of tarpaulin so shelter is still an issue and all the people queuing up outside are civil service workers who can apply for loans to rebuild their lives, but many have already used the maximum allowance after the last typhoon. What do they do now? And what if you don’t work for the civil service?!

I find the surveillance people. They’ve set up a system called SPEED and have asked all the medical organisations to report if they see any people presenting with signs and symptoms of 21 key outbreak diseases. The Filipinos are so well organised. They have been hit hard by Typhoon Haiyan but they know exactly how to respond.

I head over to the public hospital. It was severely damaged by the Typhoon. Patients are lying in beds in the corridors and on any spare chair or surface while the back of the hospital is swimming in water. In fact every building I visit seems to be leaking! The roof was almost completely ripped off and MSF is helping to rebuild it. Of course, as luck would have it, the hospital serving the poorest in the city, suffered the worst damage.