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Timeline: Emergency response to Typhoon Haiyan
“This sort of disaster is unprecedented in the Philippines. The effect is something like a massive earthquake followed by huge floods,” says Dr Natasha Reyes, MSF’s emergency coordinator in the Philippines.
“As a Filipino, I know that we’re a resilient people. We’ve been battered over and over again by natural disasters.
"So when I hear about people being so desperate, so stunned, so hopeless, it really tells me just how bad this is.”
After Typhoon Haiyan tore through the islands of Leyte, Samar and Panay, our emergency teams responded almost immediately. It was a major disaster: around 63,000 people had died, but many more needed treatment - left without access to healthcare, food or water.
Over 200 aid experts flew into the disaster zone, including doctors, nurses, surgeons, logisticians, water and sanitation experts, and psychologists. We also shipped over 359 tonnes of medical and relief items, in an effort to help those in the greatest need.
Scroll below for a timeline of our response to the Typhoon Haiyan disaster from beginning to end.
Typhoon Haiyan: Emergency response
Our initial focus was on the province of Leyte, which was hit first as the typhoon came ashore. Efforts to reach the city of Tacloban are being complicated by roads blocked with debris, as well as strong winds and torrential rain forcing the cancellation many flights to the damaged airport.
“We know that many medical facilities have been destroyed or damaged, with medical equipment simply washed away,” says Dr Reyes. “On top of this, a lot of health staff are unaccounted for, meaning the resources are severely depleted.”
Our medical teams will support the work of the Philippines military at the airport. We have identified one still functional hospital in Tacloban, which we are supporting with staff, supplies and equipment.
MSF teams are currently organising supplies of drugs, medical equipment and material to purify water, as well as essential items for distribution such as plastic sheeting, cooking items and hygiene kits.
“Usually, in these types of disasters, the main needs are related to people being displaced from their homes, and the injuries are relatively minor – cuts, broken bones, head wounds. But with so many houses and buildings having collapsed because of the strong winds, we’re expecting to see some significant injuries.”
As more staff arrive in the disaster areas, our strategy will be to continue to move outwards from Tacloban town to the surrounding region and islands. With communication networks down, there is still little information available about the extent of the damage in many remote and rural areas.
Dr Reyes adds: “Our priority is to address the urgent and immediate medical needs, of which we are sure there are many. After that, really it’s everything – shelter, water, food. People have lost everything.”
Cebu: An MSF team reached the north of Cebu island this morning. Initial assessments are that the outlying islands are the most affected. Displaced people on the northern Cebu coast seem mostly to be hosted by their families and communities. The local hospital was overwhelmed by patients immediately after the typhoon, but received support from other health centres and hospitals and is coping relatively well now. The team then went by ferry to Bantayan Island where they will stay overnight to continue the assessment.
Guiuan: Another MSF team flew to Guiuan in the east of Samar, an area hit first and hard by the typhoon and from where there has been very little information. The team reports that the damage there is extensive and the needs huge. A full team plans to return to Guiuan tomorrow by helicopter to launch activities immediately.
Panay Island: An MSF team also carried out an assessment of Panay Island by helicopter and another team is currently in Ormoc and will be surveying the situation in western Leyte.
Three of nine cargo planes have arrived in Cebu and all stock is now off-loaded.
The humanitarian cargo includes medical kits for treating wounded, material for medical consultations, tetanus vaccines, and relief items such as tents and hygiene kits.
Guiuan: The damage is extensive and the needs huge. Almost all the buildings in the town are destroyed. The local hospital is also severely damaged and not functional. The most seriously injured people had already been evacuated.
Our medics will start helping people as soon as possible, and our teams will tackle water, sanitation and shelter.
Roxas City: Our team estimates that 50 percent of Roxas City, in the north of Panay Island, has been destroyed.
Iliolo: Tomorrow, a team of two nurses, a logistician and a water and sanitation specialist will fly from Manila to Iliolo. They will try to reach San Dionisio, Estancia and Balasan in the north east of Panay Island.
Tacloban: A team was able to make it to Tacloban today by helicopter and is currently assessing the situation.
Ormoc town: The team who visited Ormoc town, in the west of Leyte province, report that the majority of the buildings are destroyed. There is limited power supply. The hospital is damaged; originally a 200-bed hospital, there is now only an emergency department with 25 beds.
An assessment by helicopter is planned for the outlying islands tomorrow. Depending on the needs, the next stage is to send mobile clinics further up the coast of eastern Samar and to outlying islands using boats.
Guiuan: MSF's emergency team are treating the first patients in the far east of Samar island, where the typhoon first struck. A doctor, nurse, psychologist and two logisticians are launching mobile clinics, reaching out to the more isolated parts of the coast and islands, and outpatient service in the town of Guiuan itself. Seriously ill patients will be able to stay in the clinic overnight.
MSF will also launch water and sanitation services as soon as possible, while assisting with shelter. Other members of the team will assess smaller islands by helicopter today, Friday. If conditions allow we will use boats to stage mobile clinics on those islands and along the coast of eastern Samar.
Tacloban: A team of four remains in Tacloban and two people are now south of Palo to assess the situation.
Panay Island: Our teams have seen that the eastern part is the most affected. We are setting up a base in Roxas City to begin activities in the coming days.
Also in Panay, following an assessment in Iliolo province, a team will now respond to the acute needs identified in the areas of Estancia, Conception and San Dionisio, where several thousand houses have been totally destroyed. Some small islands off the eastern coast have also been affected and assessments are currently being carried out.
MSF will also assess five small islands southwest of Bantayan Island.
Negros Island: Although the situation so far seems less acute than what is being reported in other areas such as Tacloban, aid delivery may still be necessary.
In total more than 100 MSF specialists are on the ground, with more on their way.
Guiuan: "In Guiuan town, every single roof has been blown off in a town of 45,000 inhabitants," says Dr Natasha Reyes, MSF's emergency coordinator in the Philippines.
MSF's emergency team in Guiuan – in the far east of Samar island, where the typhoon first struck – now has medical activities underway. Yesterday (Friday, 15 November), 600 consultations were carried out, most for lacerations and infected wounds.
"There's no roof, destroyed electricity equipment, etc," says Natasha. "It used to be a 50-bed facility with X-Ray, operating theatres, everything. The wind destroyed the concrete." We are currently working in the ruins of Guiuan's hospital, but our team is looking to set up a tented medical centre in the coming days as half of the hospital has been completely destroyed, with the other half unusable.
Tacloban: In Tacloban, a team of eight is preparing the site for an inflatable hospital, which will be on its way shortly from Cebu. A larger MSF team is also on its way to the area.
Our team is particularly concerned about tetanus infections, so a dedicated tetanus treatment zone is being planned as part of this medical set-up. South of Tacloban, in Palo town, a team of three is setting up initial medical activities.
Leyte: Explo teams including a medical doctor, nurses, logisticians and a psychologist started to conduct mobile clinics while assessing further needs in Ormoc, Leyte province.
Their focus has been on the evacuation centres where people have gathered following the typhoon, such as in community centres. They have provided some basic medical care. People say they need food, drinking water and shelter.
Samar Island: An MSF team of 26 is now in Guiuan, eastern Samar, working with local Filipino medics. There were 300 consultations on the third day.
Twenty-seven patients had minor surgery for lacerations, broken bones and infected wounds. Three patients have been referred to the only functioning hospital. A mental health team is assessing needs and organising psycho-education activities.
An MSF logistical team is at Guiuan public hospital, which was severely damaged by the typhoon, and is setting up a tent hospital.
Maternal care, including care for complicated deliveries and c-sections, is a priority as most of the secondary healthcare capacity has been destroyed. In the next days, MSF will start repairs on the hospital building.
On Sunday, 40 tonnes of supplies arrived in Guiuan, which brings the total to 70 tonnes. The lack of fuel is one of the main logistical constraints, so a boat loaded with jerry cans is leaving Cebu tonight, followed on Monday by a barge carrying about 50 tonnes of medical and logistical materials.
Leyte island: In Tacloban, a team of eight is being reinforced with 10 staff from Cebu – including medical doctors, nurses, logisticians and a psychologist – to prepare the inflatable hospital.
The plan is to have comprehensive medical services including an emergency room, inpatient department, operating theatre, post-operative ward, obstetrics and gynaecology unit, maternity delivery room, psychosocial activities, blood bank, X-ray, and an isolation ward in case of tetanus cases.
A first cargo of non-food items (NFIs) landed on Saturday in Cebu with 1,500 tents, 3,000 jerry cans, 9,000 blankets, 2,000 hygiene kits and 2,000 cooking kits.
Two more cargos are expected on Sunday and Wednesday with a total of 14,000 blankets, 3,000 jerry cans, 1,000 cooking kits and 1,000 hygiene kits.
In and around Palo and Talawan, south of Tacloban, from Monday MSF teams will provide primary healthcare at one fixed health post and mobile clinics.
MSF teams continue to provide basic medical care in evacuation centres in Ormoc town and the surrounding district. The teams have largely been treating wounds.
We are also deploying a combined mobile clinic and assessment team to the town of Santa Fe, near Tacloban. We will also provide medical care in Cebu where people being evacuated from Tacloban are arriving.
"THE SITUATION IS DISASTROUS"
In the south of Leyte Island, an MSF team assessed the needs along the coast. Among the more affected areas are Dulag town (population 48,000), on the east coast. The health facility has been partially destroyed and medical staff report an increasing numbers of patients with diarrhoea. They have received some wounded people, mainly with cuts.
”In Burauen, a city of 55,000 inhabitants, the situation is disastrous,” says Federica Nogarotto, emergency coordinator in south Leyte. “Nearly 100 percent of houses are damaged or destroyed and the hospital – formerly a 70-bed referral hospital with surgical capacity – is completely damaged.”
The team plans to set up a tented hospital with surgical capacity in Burauen. Forty-seven tons of cargo arrived in Cebu on Sunday and three trucks loaded with logistical and medical materials are on their way to Burauen by ferry, due to arrive on Monday.
In Carles, in north-eastern Iloilo province on Panay island, MSF has treated 40 patients. Teams began medical activities on Sunday, working within a Ministry of Health clinic.
On Sunday, teams carried out further assessments by helicopter of several small islands northeast of Panay island. The north-eastern coastline of Panay and the islands have been severely affected, and teams estimate 90 percent destruction.
MSF plans to establish a base in Estancia and carry out mobile clinics from there. Teams will travel by boat to reach the small islands east of Panay.
Thirty tons of drugs, medical equipment, hygiene kits, shelter and other relief items will arrive on Sunday night in Manila, to be flown to Roxas City on Monday. The supplies will then be dispatched to the teams working in north-eastern Iloilo province.
We are now able to reach and treat more and more people, and are expanding medical aid in five of the most affected areas, spanning three islands. Our emergency teams are now working in:
- the Guiuan area on Samar island
- the areas around Tacloban, Ormoc and Burauen on Leyte island
- the area around Roxas and Estancia on Panay island
While supplies of aid are now reaching large cities, such as Tacloban, there are other areas where aid has still not arrived. These include remote, hard-to-reach rural and coastal areas, but also towns like Santa Fe, which is just outside Tacloban.
Our priority is to reach these isolated communities where aid has not yet arrived.
Logistical constraints – including the massive destruction of infrastructure, congestion in airports and ports, and blocked roads – remain challenging.
MSF supplies are now arriving in affected areas by plane and by boat, and MSF teams are treating more and more patients, with over 1,000 consultations so far in Guiuan, Samar island.
Our teams are running mobile clinics in coastal and rural areas which so far have been cut off from aid, including Talawan and Talosa (south of Tacloban) and Coron island.
The team in Tacloban has cleared debris from the car park of the damaged Bethany hospital with the aim of setting up an inflatable hospital where they will provide comprehensive medical services. The inflatable hospital is due to arrive by cargo plane on Tuesday.
All teams have mental health officers who are starting to provide mental healthcare to people suffering the inevitable psychological impact of the disaster.
We are supporting hospitals in Tacloban and Burauen (Leyte island) and Guiuan (Samar island), where teams will help to restore normal medical services such as maternal healthcare and inpatient services.
In Guiuan town, on Samar island, a team is setting up a tented hospital with an inpatient ward and maternity services. The team will also provide healthcare at five health centres in the wider area, as well as through mobile clinics in more remote areas.
In Tacloban, the team is preparing to set up a 40-bed inflatable hospital in the grounds of the Bethany hospital where they plan to start providing comprehensive medical services in coming days.
All teams have mental health officers who are starting to provide mental healthcare to people suffering the inevitable psychological impact of the disaster.
MSF is supporting hospitals in Tacloban and Burauen (on Leyte island) and Guiuan (on Samar island), where teams will help to restore normal medical services such as maternal healthcare and inpatient services.
Total international staff on the ground now: 160
"The wind was so strong that it blew off the roof of the house," says one Typhoon Haiyan surivovr. "We thought it was the last day of our lives.
"It’s difficult to describe the event, it is traumatic".
Justin James Warren Pambulan was the first baby delivered in MSF's makeshift maternity and labour room on the east coast of Samar island.
The latest numbers on our response in the Philippines:
International staff: 201
Number of hospitals: 4
Number of health centres: 8
Mobile clinics: 37
OPD consultations: 6,452
IPD admissions: 58
Minor surgeries: 220
Mental health consultations: 400
Despite increasing humanitarian aid in typhoon-hit areas of the Philippines, MSF teams are still finding villages and towns that have not yet received any aid.
MSF’s teams are working in hospitals, running mobile clinics, providing mental healthcare, distributing essential relief items and clean drinking water.
In Guiuan, 1,200 tents have been distributed and potable water is being provided to over 20,000 people. In the city of Tacloban, MSF has set up a 45-bed ‘inflatable hospital’, and in Guiuan, on Samar island, MSF set up a 40-bed tented hospital.
Samar Island: We have increased the tented hospital in the grounds of the Felipe J Abrigo referral hospital in Guiuan from 25 to 40 beds. The team is doing approximately 400 consultations a day, assisting up to four deliveries and carrying out around 80 minor surgeries, mainly for wounds.
Meanwhile, MSF logisticians are continuing to clear debris from the destroyed hospital building in order to prepare for renovations.
Leyte Island: Our inflatable hospital is now fully set up in the grounds of Bethany hospital in Tacloban. Teams are seeing an average of 35 patients per day in the emergency room.
Since the beginning of surgical activities on 23rd November, some 60 surgical procedures have been performed, mainly for the debridement of wounds, but also including some caesarean sections.
We are also running mobile clinics in evacuation centres in Tacloban, as well as in the northern neighbourhoods of the city, providing an average of 200 consultations per day. Teams are also continuing to run outpatient consultations in dispensaries.
Panay Island: We are helping people affected by an oil spill in Estancia’s harbour. MSF teams have distributed 125 tents and are providing people with clean water. A medical team is providing outpatient consultations, and has started to carry out measles vaccinations for children.
We currently have six mobile clinic teams. Travelling by boat, three of these teams are running mobile clinics and distributing essential relief items. More than 10,000 families will receive hygiene kits, plastic sheeting, cooking utensils and kits containing materials for repairing damaged buildings.
7 December: One month on - the MSF response continues
One month after Typhoon Haiyan hit the Philippines, our emergency teams are still working on three of the country’s hardest-hit islands.
We are providing healthcare for people in remote areas and supporting the health system as it recovers from a disaster which killed 5,600 people and displaced more than four million, according to official figures.
As well as seting up an inflatable hospital in Tacloban, MSF teams ran a clinic out of hospital ruins in Guiuan, and reached remote communities on live-aboard dive boats packed with humanitarian relief items and medical equipment.
Henry Gray, MSF emergency co-ordinator, says: "The medical needs we’ve seen are what we’d expect after a disaster – people need treatment for cuts and contusions, they need tetanus shots. Once treated, the medical needs will soon dip, but they’ll grow if we don’t get on top of things – especially water and sanitation.”
Samar Island: In our tented hospital in the grounds of the Felipe J Abrigo referral hospital in Guiuan we saw 50-60 inpatient admissions per week. Our medical teams working in rural clinics are carrying out 1,200 consultations per week with the help of Filipino medical staff.
Our teams also distributed reconstruction kits to families on the islands south of Guiuan.
Leyte Island: Our inflatable hospital in Tacloban had a total of 54 beds for inpatients, maternity patients and for neonatal care. Activity in the hospital is high - with 80 surgical procedures and 274 patients seen in the emergency room in one week alone.
In the town of Tanauan, south of Tacloban, we set up a 25-bed tented hospital with an ER, a paediatric ward and a maternity ward.
On 11 December, a mobile team started a measles vaccination campaign targeting children living in the mountainous area around Liberty, in the north of Leyte island.
Panay Island: The 5,000 people affected by the Estancia harbour oil spill have now been relocated to the grounds of a local school. We distributed 125 tents and provided people with clean water. More than 1,000 children were vaccinated for measles.
Our teams also continued mental health work and training local staff to recognise acute emotional reactions in their patients.