Typhoon Haiyan (local name Yolanda) made landfall in the Philippines on November 8, 2013. We write this article more than a year after the storm to reflect what the World Health Organization (WHO) - muscle medical efforts coordinated with the Ministry of Health of the Philippines - learned from lessons during and after the storm, and these lessons have influenced subsequent response. and especially the response to future medical emergencies.
Coping with multiple natural disasters
The first lesson is that national agencies and international communities need to be prepared for the multi-disaster every year in the Philippines. This country is one of the countries suffering the most natural disasters in the world. Typhoon Haiyan was the third major incident to hit the country in two months, preceded by a conflict in Zamboanga and an earthquake in Bohol, which displaced 750,000 people. This means that response activities by national and international agencies and the Philippine military have been mobilized for quite a long time.
WHO Philippines has been working with the Department of Health to establish Emergency Operations Centers in vulnerable areas of the country, and set up a command system for gold, silver and copper to direct natural disaster response. This agency also reserves and determines where to store medical supplies and equipment to prevent possible disasters, and coordinates with the Department of Health to develop a set of tools to be ready to respond. deal with emergencies. These toolkits will provide process and action instructions to ensure a quick response in an emergency. Both the local and national governments are working hard to ensure that the medical structures are resilient to disasters.
Patients in field hospital. More than 600 medical facilities have been damaged or completely destroyed by Typhoon Haiyan. Photo: F. Guerrero / WHO
Well-prepared
The second lesson is that, in any emergency response, aid agencies need to be prepared for what will actually happen. Foreign medical teams need to bring enough food, water, shelter, fuel and communication equipment to be self-sufficient, especially in fragmented areas and communication areas. poor or cut off. They also need to take into account planning push health supplies before the hurricane hits and calculate the capacity to respond to medical priorities and actual damage recovery in the Philippines. Some medical teams are ready to cure the injured but do not take into account the immediate service needs of pregnant mothers or the need to replace daily medications. The country has three burden of disease: infectious and non-communicable diseases, plus the impact of natural disasters on health services that are already too stressful. The Philippines also has one of the highest birth rates in Asia: for some medical armies already accustomed to treating injuries, it's surprising that they have also had to re-learn midwifery skills. Some teams need to provide supplements from WHO Philippines to treat chronic heart disease and hypertension.
In order to effectively mobilize medical staff, facilities and medicines brought in by foreign medical teams, it is essential to systematize their deployment processes. WHO Philippines has established a registration and reporting system to ensure foreign teams are prepared before they are deployed to areas in need of assistance. WHO has helped the Department of Health coordinate more than 150 foreign medical teams in the response process. They have organized more than 193,000 medical consultations, performed more than 5,000 surgeries and assisted more than 1,200 births.
Assess and predict needs
The third lesson concerns demand prediction in the different stages of the response process. In the first phase, the first days and weeks are mainly focused on healing the injured, supplying new disabled equipment and caring for pregnant women. The second phase involves preventing outbreaks through resuming surveillance activities to track potential outbreaks and an immunization campaign across the affected area to protect children against measles, rubella and polio.
This activity is coordinated by the National Government, but UN agencies and foreign medical teams have provided important support to disease surveillance and are often involved in injection campaigns. strains. Measles is raging in the Philippines, and after natural disasters, children often live in crowded conditions, making the disease susceptible to complications and even death. In addition to poor living conditions, large-scale migrations following a catastrophic disaster are also likely to affect immunization needs.
During the first vaccination conducted in the hurricane-affected area, nearly 110,000 children were vaccinated against measles, and a follow-up campaign expanded in the Capital from January to February 2014 and 1.7 million more children were vaccinated. In addition, patients with multidrug-resistant tuberculosis and tuberculosis (MDR-TB) should be continued treatment to prevent the spread of the disease and increase resistance. The area affected by the storm was estimated to have 26,249 cases of tuberculosis with 356 cases of multidrug-resistant TB. By mid-December, almost all TB patients had returned to treatment. Other infectious diseases such as dengue fever must also be prevented, as it spreads rapidly where mosquitoes can breed in rubble or rubbish.
Natural disasters such as Typhoon Haiyan have increased the threat from non-communicable diseases because they disrupt access and provide essential medical interventions, including medications. This triggers the third wave of medical action. Non-communicable disease is one of the leading fatal diseases in the Philippines, accounting for more than 70% of all deaths recorded in the country every year. Within a few weeks of the storm, the number of patients requiring treatment for non-communicable diseases increased, and after months, the risk of heart attack and stroke increased significantly due to the stress associated with problems. inherent health problem. During the first 3 months after the disaster, 14,000 hypertension counseling and another 1,770 diabetes counseling were conducted. The need to proactively address Non-communicable Diseases before natural disasters and ensure that people receive adequate care after a disaster is an important lesson from responding to Typhoon Haiyan. WHO has provided additional resources for the treatment of Non-communicable Diseases to foreign medical teams to assist with the response as many cannot foresee the scale of the need.
Within 3 to 4 months after a disaster there is a transition from an emergency response phase to an early recovery phase. Emergency response activities such as a nutritional food supplement program will stop and free health care will run out once medical teams
