Philippines: experience

The MSF team in Tacloban, which, as of this morning, had 21 international staff members, has been occupying the three top floors of a downtown hotel.

The MSF team in Tacloban, which, as of this morning, had 21 international staff members, has been occupying the three top floors of a downtown hotel. After short nights of living on top of each other in a hotel full of distressed aid workers, our living conditions have gotten much better, as have those of the rest of the city.

The streets littered with garbage and dead bodies that I found upon my arrival last Thursday have been cleared by the agencies of the Government of Philippines with impressive speed.

The government is showing a thing or two to the throngs of international agencies that’ve been arriving in a steady and seemingly interminable stream.

This has brought to light another fact: The Philippines are the best in the world at responding to natural disasters like this. Experience is an irreplaceable advantage and this country, sadly, has plenty of it.

In Palo, about 20 km south of Tacloban, I joke about this with Dr Riviera, the local health director. “They should have sent Filipinos to Haiti to clean up after the quake, rather than those cholera-carrying Blue Helmets,” he laughs. “I was there with my team, and the coordination problems between aid agencies and the government were so bad, we got out of there pretty quickly !”

Those organisations, that go from useless evaluations to pointless meetings, going round in circles. “What’s the point of doing a preliminary evaluation if not to waste more time? The needs of the people after this kind of catastrophe should be obvious to everybody.”

Even if there are still some areas that haven’t been explored, in the rural areas in particular, the majority of villages that MSF teams have reached after innumerable logistical hurdles are in fact already occupied by Filipinos or, otherwise, by emergency medical teams dispatched by foreign armies, whose experience in terms of rapid deployment goes without saying. It’s true that having airlift capacity and priority authorisation to land are nice advantages – advantages that we don’t have.

In Palo, a large medical team from B-Fast, Belgian government’s disaster response agency, has already been working in a tent hospital for some days when we finally get there. They set up the square of the cathedral, which is now missing its roof.

The manager, nicknamed Gégé, is happy to see us. Right away, he suggests leaving us the operation, plus all the equipment that goes with it. It’s a deal!

As the explo team moves south, we get closer to the centre of the typhoon. The devastation becomes more and more complete. In Tanouan – or what’s left of it - it’s the Australians and the Filipinos who’ve preceded us.

An American man who’s been living there for 10 years tells me how the sea, with the help of massive winds, completely submerged the city.

Taking into account his nationality, I assume he’s talking about feet, not metres. “No, 10 metres,” he says, his gaze shifting to the sky. The Australians have been there some weeks now, and we commit to come and help them, as well as a Japanese team who had arrived that morning.

A few kilometres further and we reach Tolosa, a coastal village situated right in Yolanda’s path of destruction. The winds there reached over 300 km per hour, and the water swept over everything. Nearly the entire village – I’d say about 95% - has been destroyed. A medical team has been working at the town hall, still standing by some miracle, since this morning. The young volunteer doctors treat some people who’ve stayed in the village. Others have left – what’s the point of hanging around in the middle of Hiroshima?

The affected areas have been emptied. My friend Jason, the head of the ‘cavemen’, explains the dynamic to me : “We knew the typhoon was coming a week in advance. It’s certainly not the first one we’ve had. Everybody who had the means to or who had no shelter left. Those who stayed knew from experience how to protect themselves from the winds. It’s the wave that took us by surprise – nobody saw that coming. The majority of the victims who died, drowned.”

At my request, he and his gang give their estimates of what percentage of the population is still present. They say 10 to 30 per cent. “The people who lost everything went to Cebu or Manila. Just about every Filipino has a family member they can stay with somewhere else. Those who are still here have what they need to live. Then there are the thieves. All the businesses were emptied over the weekend and they don’t want to abandon their booty." NGO distribution centres are hardly having their doors bashed down.

What role is international aid supposed to play in this context? Huh. Good question, and I’ll give my two cents – feel free to disagree with me.

The emergency in such a situation is, first and foremost, to stay modest, and to treat the context appropriately. I see dozens of organisations on a daily basis that wax on in interviews with major media outlets about the risk of epidemics, when the distribution networks have already been re-established by the authorities, with water more chlorinated than a swimming pool.

And then there are those who want to teach the Filipinos to wash their hands after having been to the toilets or who think that they all need psychiatric care as they’re obviously traumatised by what is for them just the umpteenth typhoon, albeit stronger than any they’ve seen before.

The country needs to clear up and to re-establish all public services as quickly as possible, while bringing attention to the most vulnerable people. To do this, only the organisations with the logistical, human, and financial means are capable of bringing added value. The army, yes: fire service, yes: MSF and its compadres, yes. The others, these throngs of amateurs who rock up equipped with nothing but their goodwill, without a plan, without logistics, without resources, only add their own needs to those of this country. The congestion of the transportation networks generated by this humanitarian tsunami complicates getting things that are actually useful from A to B. Our inflatable hospital sat in Cebu for five days – days that are precious, as we’re talking about saving lives here.

As, beyond the obviously dramatic human loss, it’s the local economy of the Visayas archipelago that’s been hit hard. The typhoon risks looking out of place on its tourist brochures and a dishevelled MSF team in a hotel is not going to bring up its ranking on Tripadvisor. Without tourists, there are no more jobs, no more businesses, no more possibilities, no more hope. Once their lives are not directly threatened, people need work, and people need money.

I rest my case. After the emergency phase, the role of humanitarian aid in this situation very quickly becomes the distribution of money to allow the economy to rebuild quickly. A kind of large-scale insurance system following the massive damage that has been done. Large donors are reticent to finance governments out of fear (in certain cases legitimate) of stimulating corruption.

And as it remains touchy to distribute cash directly to people, a less bad solution is to finance the hundreds of humanitarian organisations who will inject money into the economy through spectacular salaries and insane rents, as they’re never negotiated. The price of a rickshaw ride in Tacloban has multiplied by 300 since the Typhoon. I leave the final word to the excellent Jason : “Humanitarian tourists are going to save the season for us. It’s progress compared to sex tourism, as long as nobody does both.”