Philippines: Specialised care for mothers and babies in devastated Tacloban

In the aftermath of a disaster like typhoon Haiyan in the Philippines, treating the injured is a priority. But it is also essential to offer the day-to-day medical care that damaged local health services are struggling to provide, says MSF doctor Daniel Martinez Garcia. As part of its emergency response in the devastated city of Tacloban, MSF has set up a maternity ward and neonatal unit to provide specialized care for mothers and children.

Is it usual for MSF to open a neonatal unit in an emergency response?
This is the first time that we have included a neonatal unit in our emergency response. This kind of service requires significant technical capacity, including electrical and medical equipment, staff with the right specialised skills and a functional operating theatre. Probably due to the stress that people suffered as a result of the typhoon, there are more women with complicated pregnancies than there would be normally. We are one of the few organisations here able to offer antenatal care, caesareans and care for premature babies.

Have people’s medical needs changed over the month since the typhoon struck?
During the first two or three weeks after the typhoon, the most seriously wounded were evacuated from Tacloban, leaving people with minor injuries only. In the weeks since then, there has been a return to a fragile normality. It’s fragile because the electricity is still down, schools haven’t reopened and the health system isn’t functioning. As everyday medical problems reappear, and emergency organisations start to leave, there is a need for the treatment of chronic illnesses and complications in pregnancy. So in addition to surgery and emergency care activities, we also provide general outpatient consultations, inpatient care, maternity services and a neonatal unit.

What are the risks associated with poor living conditions since the disaster?
Stress, dust and a lack of hygiene have led to large numbers of patients with respiratory tract infections, especially children. A four-year-old girl with asthma was brought into the hospital in a critical condition. She went into cardiac arrest and for nearly 15 minutes we tried to revive her. Finally she started to breathe.

How do you see MSF’s activities changing?
I predict that more and more children will come for consultations. The people who were evacuated from Tacloban are starting to return to the city, so there are increasing numbers of children here. Today, we are seeing more and more children with chronic diseases, but also with malnutrition related to underlying conditions. So far there have been no cases of malnutrition caused by a lack of food or hygiene due to the typhoon, but this may change in the coming weeks. We are monitoring the situation. The main challenge is to keep adapting our services to people’s needs.