Tacloban, Philippines
“
A lot has changed. Before I was focused on my outpatient consultations and at present I am more into signing of death certificates. It breaks my heart. Access to health care services – particularly in reproductive health – is temporarily paralyzed due to the severe destruction of typhoon Haiyan.” — Dr. Arlene Santo Tanauan18
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Damage to the health system Haiyan – known locally as Yolanda – devastated thousands of hospitals and health clinics in nine provinces of the Philippines. The Department of Health estimated that 82 percent of the health facilities in the affected areas were damaged, and as a result 1.1 million people, including 163,000 children under 5, suffered from sub-optimal primary health services due to non-functioning health facilities.19 Assessments found more than 2,250 health facilities were damaged or destroyed.20 Hundreds of these facilities may have been barangay (village) health stations, which provide primary health and childbirth services to people in smaller communities.21 While it is not known how many health workers were killed or injured in typhoon Haiyan, up to 50 percent were not reporting for duty in the weeks following the storm in the severely affected areas of Leyte and Eastern Samar.22 Many of those who survived had lost homes and loved ones and were in need of psychosocial support.23 “Part way through the storm one of the midwives received a call telling her that her own family’s home had been completely blown away,” said Dr. Greg Rolan Sumile in Estancia. “She was so upset and distracted that I told her she needed to leave to find her loved ones and look after them. We lost many staff in this manner. At the end, there were only four of us left.”24 Despite these challenges, many health facilities were still able to function and deliver essential health care services under tarpaulins and tents.25 Local and foreign medical teams that were deployed to the affected areas also helped keep health services available in the weeks immediately following the typhoon. Not surprisingly, many facilities reported increases in client loads and difficulty treating all who needed help.26 “We are seeing many more patients now than we did before the typhoon,” said Judith Dalton, a nurse in Estancia. “We are coping with this by working longer hours and doing things we’re not used to doing.”27 Most of the emergency medical teams have left now, and the Philippines’ health system still has not fully recovered. “The nurses look physically and emotionally exhausted,” said Krista Zimmerman, a Save the Children staff member. S TAT E O F T H E WO R L D ’ S M OT H E R S 2 0 1 4