JARO, Philippines — Even as a major international aid effort has begun to take hold around the coastal city of Tacloban, the situation grimly differs just a few miles inland, where large numbers of injured or sick people in interior villages shattered by Typhoon Haiyan more than a week ago have received no assistance.
Well away from the coastal storm surge areas where most of the death toll occurred on the Philippines island of Leyte, the picture is still one of utter devastation — in this case from Haiyan’s record winds. Mile after mile along the inland roads, particularly in the east, practically every home looks as though its roof had been ferociously clawed off.
Coconut palm forests were torn apart, with vast swaths of trees snapped off about 15 feet above the ground. Falling trunks crushed or knocked holes in houses and huts alike.
But while international relief workers in bright blue or red vests and Philippines Department of Health workers in orange vests are now scouring neighborhoods up and down the coast, they are nowhere to be seen in the interior.
Doctors, mayors and local council members in six inland towns and villages here on Leyte Island all said Sunday that their citizens had received no medical treatment or medical supplies and no food, water or tents from the international assistance program. They also had not received any medical assistance from the Philippines government; although town governments had received sacks of rice, village governments had not.
All of them said that with the exception of a handful of people sent to hospitals in Tacloban with clearly life-threatening injuries, most people with typhoon-related lacerations and other injuries were being sent home with little or no care. The inland areas lack doctors and have few if any antibiotics, antiseptic, gauze, or other medical supplies.
All of them also said that they were seeing increasing rates of fever and diarrhea, which they attributed to large numbers of people drinking contaminated water and living in now-roofless homes that offer scant protection from the periodic heavy rains over the past nine days.
Raul Artoza, a 49-year-old local council member in Macanip village, which is under the administrative authority of the town of Jaro, said that he had never seen so many children come down with fever as in the past few days.
Nobody has a thermometer in the village, nobody has taken a child to a health care worker of any sort and no aid has arrived from the Philippines government or any international group since the typhoon, he said.
“We’re just putting leaves on their foreheads,” said one of his neighbors, Milagros Macanip.
Rosalina Doyola, a 22-year-old who completed a university degree in accounting last year, sat in a clinic in Santa Fe on Sunday morning, missing two chunks of her left calf each long and deep enough to put an index finger in lengthwise. She was hurt nine days ago by flying debris and has only received iodine solution as a topical antiseptic, plus inexpensive oral antibiotics, with no attempt at suturing her wounds.
“We were escaping from our house and I was hit by an iron roof; maybe it was the church’s roof,” said Miss Doyola, adding that both her brothers had been injured by stepping on nails since the typhoon, but that her two sisters were fine.
Virginia Anoya Macasaet, the 51-year-old midwife who has run the clinic for many years, said that she had no formal training in wound care. She said that she had initially put gauze on Miss Doyola’s wounds nine days ago but later changed her mind.
“We bandaged it, but it smelled bad, so we left it open,” she said.
Mrs. Macasaet and Miss Doyola both expressed surprise when told that German and Belgian medical aid groups had opened free field hospitals just three miles away in coastal Palo. An ambulance was parked in front of the Santa Fe clinic and available to take them to Palo, and gasoline has become available again in the past couple days after disappearing from sale for a week after the typhoon.
Mrs. Macasaet mentioned that flying debris during the typhoon had also gouged out the left eye of a 9-year-old boy and that he had been sent home with little care. She asked that the mayor, who was standing nearby, be told that the town’s ambulance should be used.
Oscar Monteza, the mayor of Santa Fe, a town of 20,000 people, said that “hundreds” of people had been injured by flying debris during the typhoon. He said that his main priority with the renewed availability of gasoline was to fix and start a generator to produce electricity, but he later agreed to authorize use of the ambulance.
Miss Doyola was fortunate to have received oral antibiotics for more than a week, although they were inexpensive ones to which many bacteria are resistant. Rosaura Diola, the registered nurse who runs the main clinic in downtown Jaro, said that she rationed patients to only three of the 21 tablets they need to complete a weeklong course of antibiotics. Medicine is in such short supply after the typhoon that patients must figure out for themselves how to obtain the rest of the tablets needed to complete treatment, she said.
The clinic typically performs 70 obstetric deliveries a month, but lost its roof in the typhoon. Its upstairs is now open to the heavy rains, although the very damp downstairs still provides partial shelter. Asked how the clinic operates at night without electricity, Mrs. Diola shrugged and said, “There is moonlight.”
Clinics elsewhere are even worse: The clinic in Buenavista village is deserted and has no roof and no windows and such a completely gutted interior that it would be completely unrecognizable as anything other than a long-abandoned building were it not for the sign still labeling it as the village clinic.
All of the towns and villages visited had been without electricity since the typhoon, as temperatures have swung between sweltering heat and sometimes cool breezes after rain. In all of the towns and villages, tetanus vaccines are either out of stock or nearly so, and the few vaccines still being injected had been quite warm for more than a week; pharmaceutical guidelines call for them to be kept cool for full potency, although warm vaccines may be better than none.
Ricky Carandang, a presidential spokesman for the Philippines, said that aid shipments had begun to all town governments on Leyte Island, and these governments were responsible for passing on shipments to village governments. He expressed concern upon being told that village leaders in places like Macanip and Buenavista said that they had not received any relief, not even food, adding that, “We will look into these reports and take appropriate action.”
Inland towns and villages tend to have fewer people and far fewer dead than coastal cities hit by the storm surge. Catalina Agda, the mayor of Tunga, an inland town of 7,000, said that there had been only one typhoon-related death there, caused by a falling coconut tree, and 75 confirmed injuries. Santa Fe had 10 confirmed dead and Jaro had 13, local officials said.
But the extreme damage to housing, coupled with a tendency of inland residents not to go to a clinic when they are injured or sick because of an awareness of the limited medical supplies available, make it likely that injuries and sickness are more widespread in inland areas than anyone on the coast realizes, local officials said.
After town officials in Santa Fe were told of the assistance available in nearly Palo, the ambulance was to take Miss Doyola, the 9-year-old boy and another person there for help. But their fate was still a mystery on Sunday night.
Thomas Laackmann, the medical team leader based in Palo for International Search and Rescue Germany, a nonprofit group based in Duisberg, said that he did not know what became of the 9-year-old boy. But he had seen Miss Doyola’s leg and been concerned that her injury was potentially life threatening. He said he had told the Santa Fe ambulance crew to take her to the Australian field hospital at the Tacloban airport.
But as night closed in, and curfew took hold in Tacloban, medical officials at the hospital said they had no record of her arrival.
Source: http://www.nytimes.com/2013/11/18/world/asia/inland-no-aid-for-survivors-of-typhoon.html?n=Top/Reference/Times%20Topics/People/B/Bradsher,%20Keith?ref=keithbradsher&pagewanted=print