An Inside Look at the Conditions in the Philippines

I’m writing this brief report while sitting in the airport in Manila, Philippines on my way back from leading the first CMDA Global Health Relief team. At the invitation of the Salvation Army, our relief partner, I led the initial team of two other doctors and a logistician/photographer to the Philippines. We left on November 20, flew to Manila and met briefly with the Salvation Army (SA) national leadership at their headquarters before traveling south to Tacloban on the island of Leyte. It was the epicenter of the path of Typhoon Haiyan.

We landed at the severely damaged airport on a peninsula that had been scrubbed shore to shore by the 15-foot storm surge. The U.S. military had bulldozed the debris off the runway, brought in a mobile radar unit and were managing the stacked up traffic of military planes and helicopters. The shell of the terminal was stripped of most of its roof and much of its concrete structure was damaged. Blown out window glass and water stood on the floor as we passed through the terminal to the parking lot. 

As we entered the city, our vehicle weaved its way down a single lane around huge piles of debris shoved to the side by a road grader. Too often, the pungent odor of decaying bodies, 10 days old and hidden under the rubble, penetrated through the laboring air conditioner. A large truck parked by the side of the road was half-full of black body bags still being loaded by searchers wearing masks, gloves and protective clothing.

The most deadly typhoon in recorded history left destruction everywhere—roofs blown off, palm trees snapped like twigs and every window blown out.  Yet the tidal wave did the most damage. Entire ships stood in streets and cement block and poured concrete buildings were shattered by the wave’s power.

We arrive at a small SA Corp (church) in the north of the city, which had less damage. It was filled with 30 Filipino staff and three relief specialists from the Army’s international headquarters sleeping on its floors. As we stepped out of the air-conditioned vehicle, the sauna-like heat enveloped us and I began to profusely sweat. That wouldn’t stop, day and night for the next 13 days. 

Out of space, the Salvation Army had just rented a damaged house across the street where we could lay out our sleeping pads and put up our mosquito nets as darkness enveloped us around 5:30 p.m. All four of us slept side by side in one small room. The nets were for more than flying insects as there were thumb size roaches and rats in the house. I was warned that the roaches will bite you on the eyelids, but the rats prefer your feet. We were coated in insect repellent day and night, but the swarm of mosquitoes were experts in finding any square centimeter left bare or in sucking blood out through any thin area of clothing during the day or where your skin touched the mosquito net at night.

We “showered” with a dipper and a half-bucket of water drawn from a shallow “well” in the front yard just five feet from an open sewer on the side of the road. We were advised to keep our mouths shut when bathing to avoid amoeba infection. Then we immediately applied more bug spray before crawling under the netting in a pair of shorts. Only Ambien afforded sleep as we sweated through the night. 

The “health cluster” led by the Philippine Ministry of Health assigned us the next day to help staff a district hospital in Baybay City on the other side of the island, but upon arriving after three to four hour drive, we found that a Chinese hospital ship had arrived in their port the day before and sent 40 of their doctors and nurses to commandeer our work site. Instead, we held a clinic at a church south of town, slept in a room above it and head back to Tacloban the next day, checking communities for medical needs as we drove.

All the easily accessible towns and hospitals are well covered, so we turned our attention to the barangays, villages far off the main road. We held daily clinics at unmanned community health centers or schools among devastated rice paddies and coconut groves. Almost every patient we saw had lost all or most of their small houses. Each had a story to tell. The few cars in the community were destroyed. Only a few motorcycles survived, but fuel was difficult to obtain.

Unable to travel, they had run out of chronic medicines, some still had untreated trauma and there was an unexpected number of patients with severe undiagnosed hypertension with systolic BPs of over 200. Many had upper respiratory infections passed by crowding in the few places they could find shelter at night. It had progressed to pneumonia in some, especially the young. The sickest we transported to a hospital in our van as we headed “home” each evening. We had wonderful help from a missionary nurse and young doctor, both fluent in the local language. Salvation Army volunteers and local teachers helped with translation and, as we left the people couldn’t say “thank you” enough.
By our second week, a follow-up GHR team of four doctors and three nurses arrived, while the doctors who originally accompanied me left on various days to return to their jobs. We added measles, Vitamin A and Polio vaccines for the children under five, often in the same room with a local midwife assisting with the injections. During all the medical treatments, there was also prayer with patients, a counseling site with a Salvation Army officer pastor and offer for prayer as they got their medicines from our two suitcases and a trunk pharmacy.

A couple of days ago, I flew out of Tacloban as Dr. Sam Molind and two others arrived in Manila. Together, we met with SA officials and planned. It will take another month or so for their medical system to recover. Lord willing, we will be helping until mid-January.

Pray for Sam, those working with him now and those coming over the next weeks. The living conditions are very difficult and the chance for disease is high. We have already had to give IV rehydration to two SA staff and one other was in the hospital overnight. Pray for strength, wisdom and safety. Driving in the Philippines is a game of chicken as people move out of their lanes to pass slow moving motorcycles and bikes.

We now have our first Global Health Relief joint project under our belt, and the Salvation Army’s international health coordinator is enthusiastic about CMDA’s continued partnership in other crises.
It’s been a very long two weeks, but it was worth it. Helping people out of the unexpected ditch of suffering and despair is not easy, but we need to be there. It is what Christ would do.