My experience working as an Emergency Logistics Officer for the International Medical Corps in response to Typhoon Haiyan (Yolanda).

December 14, 2013

I’ve been in the Philippines for almost two weeks now, and I thought I’d write an update on my life here.

I landed in Cebu on Dec. 2, after a vortex of a plane trip that swallowed me up in Minneapolis and spit me out on the other side of the world.

The city of Cebu has become the hub for relief operations. It weathered the typhoon with minimal damage, it has a functional port and good market access, and it’s close to the affected area – 6 hours by ferry, 30 minutes by plane. Our Cebu-based logistics crew procures supplies based on requests from the people at the field sites. This means they either buy stuff in malls or markets, or order it from international suppliers, or request it from donors. Whatever the route, they do their best to support those working in the field by getting the things they need sent to them as soon as possible.

I spent the first few days of my contract there in Cebu, unjetlagging myself and getting a feel for my job. My second night in-country we headed down to the airport to unload a 747 full of 250 pallets of different aid items – food, tents, generators, medical supplies etc. Being on the tarmac to watch the process was a rush. In front of me towered the massive jet, and in the distance sat the C140s from the Royal Australian Air Force, preparing to fly goods and aid workers to Tacloban, Guiuan, and other severely affected areas.

Before our pallets could be dispatched to the field sites, they had to clear customs and be released from the shipping company’s warehouse, a whole process in itself. Luckily the Philippine government set up a “One-Stop-Shop” for processing relief supplies. Representatives from the Department of Social Welfare and Development (DSWD), the Department of Health, The Bureau of Food and Drugs, the Ministry of Finance (MoF), and the Department of Foreign Affairs (DFA) established a center where organizations (like us) awaiting big shipments of aid could come and get all the entrance/transportation papers stamped in one stop. It actually saved us a lot of time and energy. I think it’s a great example of how the Philippine government has paved the way for relief organizations to do their job, and it’s one of the reasons this response has been so efficient.

The next day we shuttled around a pair of German donors (who had funded the 747) so they could see where their donation was going and how it was getting there. That felt odd, that so soon after the disaster, we had to spend a day catering to foreign donors, a day that could have been spent procuring and dispatching relief supplies. But as my supervisor explained, without inspired donors, there’s not much we can offer the people in need.

I left for our operations base near Tacloban the night of Dec. 5, after a long day rushing around Cebu’s malls buying some key items for the field team: motorcycle helmets, rain coats, rubber boots, back packs, 3G wifi hotspots and of course, chocolate.

I arrived at the base early the next morning, after taking an overnight ferry from Cebu to Ormoc, then driving 3 hours across the island of Leyte. The ferry was packed with families returning to their homes, or what was left. One man told me they had to get back to plant the rice.

Our field office is located just south of Tacloban, in a town called Tanauan. I’m working with a team of about 20 people – 5 expat coordinators, and a crew of national doctors and nurses that came in from other areas of the Philippines to volunteer. After a disaster like this, IMC tries to move away from staffing their clinics with international medical volunteers as quickly as possible, and instead use local clinicians. The nationals are generally lower maintenance, harder working, and more attuned to the cultural nuances of healthcare in their country. They’re all really nice, and we all tend to get along, which is surprising considering we all share one bathroom.

We’re living in the top 2 floors of a family’s house. After the typhoon, many of the bigger houses still standing were rented out to relief orgs: the aid workers get a place to base their operations, the family gets an extra source of income to rebuild. The house we’re in is a 3 story cement building. The family who owns it runs a store out of the 1^st floor, and the father is the “Mayor.” His generator runs the street lights once the sun goes down, and in the aftermath of the storm, he’s put people to work rebuilding his warehouse.

There’s a lot to rebuild around here. Every village in the area is covered in broken sheet metal, trash and rubble from collapsed homes. The roads have been cleared, but they’re still lined with the makeshift tarp shelters of those displaced. Some have cardboard or plywood signs saying something like “HELP – NEED FOOD AND WATER.” There are also a lot of fires from people burning rubble as they clean up. Some nights it’s really smoky, and looking out from our balcony through the haze makes me feel like I’m in Apocalypse Now.

The days are long, but they go by fast. Up at 5:50, breakfast of eggs, rice, and some form of canned meat at 6:00, then check emails and start work. We recently got a shipment of reproductive health kits full of condoms, birth control, etc. that the clinicians are distributing, and so I restock them before the teams head out at 7.

Right now we have three teams, each composed of at least one doctor and some nurses. They go to three different villages a day, set up mobile medical units (MMUs) at the local health center, and treat patients till around 3pm.

Once they’re out the door, I update the excel sheets that track the use of medical supplies (gauze, tweezers etc) and pharmaceuticals. Then lunch: usually ramen and more rice, eggs and canned meat. Then I take supplies/medicines from our storage tent and stock them so the clinicians can replenish their kits when they return. I check that stuff out for them at around 5pm, then more excel before our team meeting at 7. Then dinner, misc work and emails, and if I’m lucky, a beer or two from the “bar” downstairs before bed at 11ish.

Based on what we’re hearing from the command team back in Cebu, we hope to wrap up the MMUs within the next week or so. The lines to the field clinics are growing thinner by the day and the pre-storm healthcare infrastructure is coming back online. There actually seems to be an overabundance of international medical missions providing direct patient care. We’ve heard reports of families going “doctor shopping” (showing up to multiple field clinics in the same day to get double the care and double the meds), and we’ve had problems getting the nurses, midwives and support staff who were working in these areas before the storm to show up and do their normal job. They (understandably) see the international medical missions working in their community as an excuse to ease off their duties, especially so close to the holidays (Christmas is HUGE in the Philippines).

The issue we’ve been trying to sort out now is how to dissolve our medical operations so we aren’t replacing their healthcare system and delaying the area’s recovery to baseline (pre-storm conditions), but how to do so in a way that doesn’t abandon anyone who needs us. It’s a tough line to walk, but we’re in the process of transitioning away from clinical care and towards programs focused on delivering nutrition and WASH (water, sanitation and hygiene) to the affected communities.  Although my job day-to-day is a lot of record keeping and I have little to say in terms of decision-making, it’s fascinating to watch our mission evolve right in front of me, and more than anything, it’s fun to be part of the team.

Love and hugs and happy holidays,

Will