Team 5 – report of Michaela Spoettl San Joaquin 01.01.-15.01.2014 – part 2

3.1.

Arrival in Tacloban at 7 am. Already with the landing approach we see hundreds of tents that stand between the destroyed houses and snapped palms. Water is everywhere. It is us and local visitors in our plane.

After a very uncomfortable landing we are welcomed by the NAVIS team leader on site. We take our luggage and are on our way to the camp in a colourful taxi. We are anticipated with joy. The efforts of the last weeks are written all over the team’s faces. They are looking forward to home, but are sad about the farewell as well since they all had touching experiences and new friends in the local population.

We start with the handover and briefing because the departure of team 4 is already in 3h. We are introduced to a perfectly managed and well equipped pharmacy. We also move into our sleeping tent, visit the kitchen with fridge which also contains our vaccines and get told to put absolutely no paper in the toilet. The toilet is the only leftover of a house. The shower is built from pallets, we are looking forward to using it in the evening. It is comfortably warm but very damp; we have the feeling to “leak”. This is why we are very glad about the NAVIS-water (although the taste needs getting used to)

We get a first impression of the weather. It starts to really bucket down. In a second the rear ground of the pharmacy tent is wet, before we manage to close the tent.

We pharmacists and Florian, our doctor, go to the Midwifes, an US organisation that offers prenatal care and delivery as well as basic medical care for free. We will come here in the afternoons to offer physician support. After a visit to the Spanish Red Cross (we are impressed by the sunken forlift) (they produce water for the population here and give it away for free) we return to the camp, where the departure of team 4 is about to happen.

Farewell from the mayor, last commemoration with candles at the communal grave of the church and team 4 is off to the airport.

We start with our work straight away. In the medical tent there are several cuts, infected wounds, feverish children, cough and cold as well as asthma. We handle our work easily. The teamwork with the doctors is very good. The interpreters are very dedicated. Nelson will leave us on Monday. He is teacher and on Monday school finally starts again for the children.

Lisa, our medical student, helps eagerly. She worried that she would not be able to help, but besides changing dressing, aspirating syringes and other tasks she gains insight in sewing wounds, ultrasound, auscultation, vaccination etc.

Again and again people thank us. The children are very communicative, they sing, play, get water, sit with us and surprise us with “Play with me”.

At 6 pm we finish our work. Ravenously we eat our French MREs with appetite; rice with tinned salmon and mini cheese fondue is my dinner. Claudia enjoys cold tuna salad. After that, we sit together with a cool beer, at 8.30 pm I sink in my cot and not even the power generater behind my tent wall can keep me from sleeping.

4.1.

I set my alarm to 7 am, at 8 we want to start work. Since the church bells wake us at 5, I need to realize that I am the last to get to the breakfast table at 6.15. It is already very warm; we prepone our meeting and the men climb on the school roof, as long as it is not yet too hot. Today it is dry, but the sun burns merciless. Everyone needs to put on sunscreen, wear a hat and drink a lot. We already had the first sunburns yesterday although it was cloudy all the time.

While I write here, a girl is operated at her knee in the medical tent in front of me and cries quietly. Although everyone here is very brave, it still hurts and there is also fear. A small cut got infected and needs to be lanced and cleansed. After that the girl gets a Tetanus shot. We register all the vaccinations and hand the data to the Philippine Health Ministry.

There are 40 degree in the medical tent, a great burden for our team. At 10 am I have alredy drunk 1l, my skin is wet and sticky. Fortunately, we have loads of clean drinking water.

Infected wounds are our main problem. Due to the heat and the very high humidity the germs have an easy job.

We give away antibiotics and painkiller. Also antihypertensive medicines. Again and again I look into friendly faces. The people and especially the children trust us blindly and show us their gratitude.

The technical team waits for constructing material in order to continue with the school roof. The heat and the high humidity are nearly unbearable. The children sing us hits. The power generator roars. The locals are in gumboots or flipflops on their still wet properties to tidy with bare hands, shovels and wheelbarrows. Everything from the roofs, that is still left, gets protected and covered with rainproof covers, also with the help of NAVIS. Many built simple huts with planks. The washing (yourself and the laundry) takes place at burst water conduits.

Around noon a small boy is brought who fell from a motorbike. Here the whole family rides on one bike without protective clothing and considering the reckless traffic, I am nearly wondering why there are not more accidents. The boy was quite lucky under the circumstances, other than a few severe bruises and the shock nothing happened. Just hope that the wounds don’t get infected.

Florian, our doctor, Lisa, the medical student and Claudia drive to the Merci-sisters who have built up a delivery ward in Dulag. There are 3 children per day – or better night. Meanwhile the word has gotten around there that there are nurses and a basic medical care on site. This is why we support this work in the afternoons.

Our paramedics and I stay here to dress more patients and give out medicines. I can help with dressing and give out painkiller. At 4 pm everyone is gone. I make coffee for the men on the school roof who have to stop their work as well because it starts to rain again. Florian, the technician, needs urgently to rest; he burnt himself out on the roof in the sun. The drinking water treatment plant still needs to be maintained. Today I am going to cook, since I have time; we have fried vegetables with spaghetti and fruits for desert. In the evening we want to got for a walk together. Anyhow, everyone is looking forward to a shower.

I (Claudia) went tot he Midwives with Lisa and Florian in the afternoon. The drive takes about 30 minutes – the condition of the roads is not very good (they might have not been the best before as well..) and due to the style of driving of our driver we get shaken up even more. He sits quite cool in the front, sometimes I believe, he can’t really look over the steering wheel. The side windows are full with stickers, he sometimes need to open them in order to see if anybody is coming from the side. Everybody honks while driving – Attention, I am coming and I hold my ground!

We are wistfully expected at the Midwives. They told all the patients who need a doctor to come again this afternoon. In the rear part of the tent there are a few women breastfeeding. Among others there are twins and the husband helps his wife breastfeeding by holding the second child to the other breast.

And it is warm again, although it is a white tent. The patiens are meny little children, mostly “cough and cold” – sometimes you can’t hear anything with auscultation. Maybe they just wanted to see our doctor.

A little girl, about 1,5 years old, has distinct asthma, you can clearly hear the stridor. It is supposed to inhale again at the midwives and you clearly see the improvement after that. Another 9-year old girl has no appetite, the urine is highly concentrated and the eye bulbs slightly yellow. After an examination Florian explains the mother that she should go to the hospital with her because it could be hepatitis. Some have asthma. Together with the doctor and the medical student I discuss the therapy. A very nice and yet unfamiliar teamwork. We control some wounds and need to go home although there are many patients left, because it is already dark at 6 pm. Our team misses us already and calls. At the hard shoulders of the street little fire are burning – waste disposal.

I am looking forward to dinner, that is very delicious, because there is no time for food during the day. From time to time a treat or cereal bar help during the day.

Subsequently, we have team meeting and enjoy the evening with candle light. Suddenly a mother comes with her grown-up daughter who suffers from asthma that has escalated psychosomatically since the typhoon. We give her a salbutamol MDI and explain the usage. Se hyperventilates with excitement, starts to collapse and very quickly, yet calmly the medical team give it everything, sedate her a little bit and and everything normalizes again. It is a little bit difficult, because we don’t have all the medicines for those critical situations that the doctors are used to from Germany. With some creativity we still manage the situation. By now somebody got our interpretor Nelson from a party and he can help us to explain everything to the patient and her family.

Our technical team gave out 6500l water today!!

05.01.2014 – Sunday

Michaela and I decided to go to church today. The bells ring only at 6 am not 5, so we can get up later.

As we still have time, I go to the cemetery in front of the curch with Lisa. Children run around, a small boy adjusts the soil on one grave – caring, as if he could carpet somebody.

At 8 am the service starts.

After the service we work in the hospital and the pharmacy again. Like always we need to change many dressings. Coughs become more frequent. But we also have severely sick people. A young man has an inoperable tumor in his head. He can’t feel his right arm anymore. We can’t help him anymore except for giving him remedies for seizures and painkillers. It is endlessly sad to know, that he will die soon.