TACLOBAN, the Philippines — Richard Pulga, a 27-year-old farmer with thick black hair and a gentle manner, has been lying on a hard steel bed in a dark hallway of the main hospital here since Saturday with a shattered lower right leg, abdominal pain and his right eye filling with blood.
One of the first victims of Typhoon Haiyan to be brought to the Eastern Visayas Regional Medical Center, Mr. Pulga was given just an intravenous drip — a bag of saline solution to prevent dehydration. No painkillers, no antibiotics, not even antiseptic to dress the purple, bulging wound on his calf.
He needs an X-ray to assess the damage to his leg. Miraculously, the hospital’s X-ray machine made it intact through the typhoon and accompanying storm surge, which partly flooded the hospital’s main floor.
But the hospital lacks even the electricity to turn the machine on to check if it works. The only source of power is a gasoline generator the size of a small clothes dryer, which powers the lights in the emergency room and a simple operating room.
Food is in short supply — Mr. Pulga receives just two small bowls of rice porridge a day. “The government should do more for me and fellow victims,” he said. “It’s not enough, we’re almost starving here.”
Almost everyone in Tacloban, a city of 220,000 that absorbed the heaviest blow from the typhoon, has lost family members; Jerry T. Yaokasin, the vice mayor, estimated that 90 percent of the city’s employees were either killed or injured, or had a family member who was. Many, like Mr. Pulga, were hit by debris scattered by the typhoon, one of the most powerful ever recorded in the Pacific.
As he lay on the thin, striped cloth mat that was his only cushion against the bed, Mr. Pulga recounted his odyssey.
As the storm approached, Mr. Pulga sent his wife, 7-year-old son and 6-week-old daughter to stay with neighbors in a sturdier home, where they survived without serious injury — physically, at least. Traumatized and depressed, relatives say, his wife has not yet summoned the strength to visit him at the hospital.
Mr. Pulga stayed behind to guard their small, wood house. He tried to hide from the wind by hunching down behind the back of the house, only to find the wind and rain swirling in from every direction. A large coconut, accelerated to extraordinary speed by gusts that may have exceeded 200 miles per hour, rocketed through the dark and struck his leg, breaking it.
As he lay alone and injured, the wind tore the house into little pieces and flung them into the night. He was hit by a chunk of wood that bloodied his eye and cut the right side of his face. His 16-year-old nephew, at the home of one of Mr. Pulga’s sisters, went outside to take a quick look at the storm and was struck by a piece of wood so heavy and sharp and moving so fast that it severed his leg, eventually killing him, Mr. Pulga said.
A neighbor brought Mr. Pulga first to a village clinic, where a wide, rectangular patch of gauze was firmly pressed to his leg wound with four long strips of white surgical tape. Then the neighbor brought him to the hospital here.
As they live roughly two miles from the ocean, they did not have to deal with the 13-foot storm surge that flattened large areas of Tacloban. One of Mr. Pulga’s biggest worries is how to feed his family. The typhoon destroyed the vital rice crop, almost ready for harvest, on the meager two acres that he farms with his sisters and their families. The extended family is mostly women, and Mr. Pulga said that he needed to be healthy to do the heavy work of farming.
“I don’t have any money, I’ve lost everything, even my house is gone,” he said. “That’s what is on my mind.”
The storm also snapped off most of the coconut palms on his land that help provide sustenance. It will take a few years for them to start producing coconuts again, said Luminada Florendo, Mr. Pulga’s aunt.
Coconuts, a source of food, fiber and charcoal, become a menace during powerful typhoons. The hospital bed parked in front of Mr. Pulga’s in the hallway held a young man, Junlie Bueno, whose lower back had been broken by a wind-thrown coconut, leaving him paralyzed from the waist down.
Ms. Florendo changed Mr. Pulga’s T-shirt on Tuesday. But he has not bathed or changed his black shorts since the typhoon struck. The hospital is sweltering because most of the windows are broken and, in any event, there is no electricity for air-conditioning.
The hospital’s intensive care unit is closed for lack of electricity and supplies. The pathology lab was destroyed in the flood, as was the blood bank.
The stench of putrefaction wafts from bodies buried in the debris of the adjacent neighborhood, so nauseating in large areas of the hospital that visitors and medical personnel sometimes use handkerchiefs, masks or their shirts to cover their noses. The hospital floor still has a layer of scummy mud left behind by the floodwaters, which were only calf-deep in the emergency room but more than head-high in the ground floor of the administrative wing. Trash, including broken bottles, still litters the hallways.
Medical supplies of all sorts, even the most basic, are in extremely short supply, said Dr. Faith Alianza, a senior doctor at the hospital. The hospital is out of antiseptic and is running out of tetanus vaccine, gauze bandages, sterile gloves and antibiotics, she said.
The hospital also needs food and drinking water, and there are not even enough candles for illumination.
“It’s really dark at night,” Dr. Alianza said.
The hospital is busy, but not overwhelmed. Aware that it has few supplies, people have headed instead for the handful of small clinics that foreign aid groups have set up near City Hall. Those have been almost inundated with people seeking treatment for lacerations, fractures and other minor injuries, as well as tetanus injections.
The International Red Cross and other aid agencies are trying to rush medical and other supplies to Tacloban, but have encountered delays. On Sunday, a hungry crowd tried to hijack a Red Cross truck convoy, which was forced to turn back.
Another worry for Mr. Pulga is his abdomen — he blamed food poisoning for the pain he felt there, but the hospital staff denied using any rice that had been contaminated by the floodwaters.
As Mr. Pulga described his family and worries, blood abruptly began leaking from his leg. It gathered into a bright red puddle on the mat, then began to drip onto the floor.
Alerted to Mr. Pulga’s bleeding, two health workers changed the original, five-day-old bandage. They donned latex gloves from a box conspicuously labeled nonsterile and they ripped open two packages of sterile gauze and firmly taped them to his leg, stopping the bleeding.
A doctor briefly examined the wound and spoke to Mr. Pulga as the health workers bandaged his calf. The doctor left before he could be interviewed. Ms. Florendo said that the doctor had told her that it would be very expensive to treat Mr. Pulga, and asked her if she would like to take him home.
Ms. Florendo said that her relatives and neighbors had also been left destitute by the typhoon, so there was no one she could turn to for money for his treatment.
Along with Mr. Pulga’s abdominal pain were two other disconcerting symptoms, Ms. Florendo said. His foot is paralyzed below his wound, and he is losing control of his urinary tract.
In a different part of the hospital, a Belgian government medical team was visiting in preparation for opening a field hospital nearby. Dr. Frank van Trimpont, an anesthesiologist and the senior member of the team, said that while he had not seen Mr. Pulga, the prospects for patients with such injuries were grim.
The abdominal pain and loss of urinary tract control are possible signs of a back injury that Mr. Pulga may not remember, Dr. van Trimpont said. More ominously, perhaps, the lack of antibiotics or even antiseptic for the leg injury make it likely to become infected.
“In this situation, there is not much you can do for such a man,” he said. “He sounds like a lost case.”
Source: http://www.nytimes.com/2013/11/14/world/asia/at-a-philippine-hospital-survivors-face-quiet-despair.html?n=Top/Reference/Times%20Topics/People/B/Bradsher,%20Keith?ref=keithbradsher&pagewanted=print
