Direct Relief 50 Ton Airlift Arrives for Haiyan Relief

It's arrived!

Can't really explain what this shipment will mean for the people who are suffering from the Typhoon and in need of help. It's an amazing range of products including antibiotics for 80,000 people and oral re-hydration and nutritionals for people who haven't been getting enough food and water. 

It's unreal the efforts that have been put into this to make it happen. From the companies donating the products, to FedEx donating the plane, to the countless hours of staff time, and to the incredible generosity of the  people and companies we have met here who are providing us trucks, warehousing, lodging, and plane rides all for free. The support-- It's been overwhelming. 

I have to give a special mention to Lila and Atty Patty who have been our fixers, travel agents, press office, translators, historians, and negotiators for everything we've done here. They say the new company they're forming is going to be called "Challenge Accepted" 

What's amazing about all this support is that it's enabled our response so far to be extremely efficient. Almost everything has been free. Thanks to the donations from health care companies and air freight from FedEx, we've been able to deliver over $10 million worth of medications essentially for free. It should make anyone who donated money to Direct Relief feel extremely good about the use of those funds. That often doesn't happen in the aid world.

Even right now, we are on the road to deliver a truckload to northern Cebu and a it was donated by DB Shenker, a global freight forwarding company. Same for the IPI warehouse where it's all being stored.

Out of Necessity

As we've traveled around to these hospitals in the Typhoon- affected areas, there's a few things that keep coming up and they are striking. And give a good illustration of the medical situation in some of these places.

First, so many of the doctors here are actually surgeons (takes only one extra year in med school) but so many of these facilities aren't set up for surgical procedures and don't have the equipment they need to perform surgeries. So far, none of the rural hospitals have had a ventilator. Seems quite a shame.

It's also become clear that many of these same doctors, also get their nursing license and eventually move to the Unites States and become nurses. Licensed surgeons moving to become nurses is not how you'd expect it to happen.

Photo: Jodie Willard

Supplies in these hospitals are seriously lacking. In three different hospitals, they've said their primary need is for cotton balls. And since they cannot get them, they have nurses tear off sheets or pieces of gauze and roll them into cotton balls and then sterilize them for sterile cotton/gauze.

And lots of babies. All the time. 5-10 per day in some places where they only have one "delivery table" and two or three post-delivery beds for the moms and new babies. We've seen three moms and three babies (that's 6 people) sharing the same bed--all sleeping perpendicular on the bed.

Thanks Dr. Gross

I wanted to write a quick note to thank Dr. Doug Gross for coming with us to assist Direct Relief's response after Typhoon Yolanda. Doug left us today to head back to Davis, CA to his wife, five children, pediatric medical practice, professorship at UC Davis, and position on the Federal Disaster Medical Assistance Team.

When I first wrote to Doug to ask if he wanted to come with us, he thought I was joking. I don't usually travel with any medical professionals when responding to emergencies, but knowing the size of this tragedy and after spending some time with Doug in Haiti, I knew he would be the perfect person to have on this trip. And it almost didn't happen.

Two nights before we were scheduled to leave, Doug called me and I could tell he was unsure about the trip. Not that he didn't want to go or didn't think he could help, but he is an extremely busy guy (see the second sentence of this note) and had to call in some favors to get everything covered. So we hung up at 10:30pm after deciding he wasn't going to come.

Photo: Jodie Willard

But he called me back just before midnight after spending an hour and a half watching the news and decided he had to come. After seeing so much devastation and so many people injured he decided that it would be worth the sacrifice to come and do what he could to help--even if it was only a small amount.

Well it was worth it. Doug was an amazing resource and provided us with a huge wealth of knowledge on medicines, medical conditions, and how we could best use our resources to help the people here. He was also able to look in on some children in the hospitals we visited (of which there were many) and provide some medical care to the children in these hopsitals.

Photo: Jodie Willard

If for nothing else, I think his trip was worthwhile when I saw the look of relief in one mother's eyes when Doug examined her tiny baby who was in the hospital with dengue and told her that her child was going to be ok. He may not have even noticed it. It happened in just a moment and I'm sure he sees it all the time, but it was clear to me. And I could see the weight lift off her shoulders.

Thank you Doug.

Ingenuity

It's after midnight here after another extremely busy day and we're up at 5am tomorrow to head to the northern tip of Cebu and over to Bantayan Island so I can't write much but I have to mention this story.

After meeting with the local Red Cross, the local Disaster Management Agency, and the Governor of Cebu, an extremely gracious and friendly man, we headed north to Bogo, a city on the NE coast of Cebu which was hit hard by the Typhoon. Over 90% of homes were damaged and over 500 families are living in shelters according to the local officials.

We arrived at the Provincial Hospital and found the Israeli army/medical team had set up their field operations in the yard of the hospital and were treating hundreds of patients per day, many of whom were injured in the Typhoon. These guys were also some of the first on the scene after the Haiti earthquake and performed surgeries on patients who suffered some of the most traumatic injuries. They arrived into Bogo about 4 days after the Typhoon in their military planes and arrive on-site as a fully-functional trauma care hospital. They did some major surgeries after the Typhoon but are now transitioning things back to the local hospital as it settles down. 

Photo: Jodie Willard

Inside we met Dr. Carlos Layese Jr, a Pediatrician and the Chief Medical Officer of the hospital. The place was bustling--over 200 babies born every month, TB isolation ward, busy operating theater. Every single bed was full when we went there, in fact, they are an 80 bed hospital with 150 patients inside, so the hallways were jam-packed with patients. Dr. Doug Gross, a pediatrician and a memberDMAT team, got to spend some time with patients, including a three-day old baby with pneumonia who was having an extremely hard time breathing. Looking at this baby, you could instantly tell something was wrong because her whole body moved up and down as she struggled to breathe at an incredibly fast pace. They had her on oxygen and IV antibiotics and Dr. Doug said that was the correct procedure and hopefully the antibiotics would kill whatever it was making her labor for breath but it was still very hard to witness. The fear is that if she gets any worse, they don't have a ventilator for her to use and so eventually she won't be able to breathe on her own any longer.
of the US Federal

Dr. Layese and Dr. Gross with the Israeli MRE

It's incredibly sad to see something like that where for a lack of a piece of equipment, a mother might lose her child. It's not for any lack of medical care or training--just a simple lack of a material good--which happens to be what Direct Relief focuses on. However, these are the times when you see true ingenuity come out as well. Dr. Layese showed us the pediatric ICU where they did have one working incubator. However, whenever they had to transfer babies to another facility, they never had a good way to keep the baby warm, that is until the Israelis came with their cases of MREs. As I now know after eating my first MRE in Tacloban, they come with a heating element that activates when surrounded by water. Well, Dr. Layese realized that same heater that is usually discarded from the MRE after it's used, could be used inside the incubator to keep the baby warm in transit. So now when they transfer babies, they carefully surround them with these mini heaters to keep them warm on the 2 hour journey to Cebu city.

Check out our Photog Jodie's Blog

http://jodiewillard.com/blog/

Made it to Cebu

Photo: Jodie Willard

We left Tacloban today and flew to Cebu after an extremely productive, yet devastating, couple of days. It's pretty tough to comprehend the destruction that this storm caused--on par with the Moore, OK tornadoes but in a vastly larger area. Power lines are all dangling from the air, there is no running water, timber from houses look like matchsticks and they blanket the ground for as far as you can see. There's no food or water to to be had on the island other than the bits that are being distributed so people are leaving by the plane and boatload to refugee camps in Cebu. Many people are literally starving. At one point we saw a food truck distribution line that must have gone on for a mile. When we walked down an alley to give some food out to a family thinking we could remain largely inconspicuous, we were instantly swarmed by another 50 or so people and unfortunately didn't have enough to go around.

Our night consisted of a meal of MREs under flashlight in a seriously damaged Leyte Park Hotel which has become a hub of humanitarian activity. Tents and hammocks are set up in every flat part of the yard and in any trees that are still standing. I know people say the aid efforts have been slow to arrive and help the people (although logically when you think about it, it makes sense as orgs have to organize personnel, supplies, and equipment from all over the world and try to get it all into the same small space--in this case an island chain--at the same time when the airports and seaports are all damaged as are the staff who work in them) but it sure is here now. The hum of generators can be heard all night as people are frantically making their plans for the next day.

Jodie somehow managed to get us into a room, which of course didn't have electricity or water, and inside it looked like everything had been left just as it was when the storm hit--like the people who were there 10 days before left and never came back.

In its previous state, the hotel would have surely been an amazing place. The rooms had amazing views and I took my place out on the deck and managed to sleep outside until it started raining on me in the early part of the morning.

I will try to make some sense of what we saw and heard in the hospital visits we made yesterday and how it is that these people have such amazingly positive outlooks on things. But I'm not quite there yet. Still baffles me.

Local News

Haven't seen it yet, but I think we were on Philippine local news last night. The GMA and anchor Vicky were extremely gracious and helped us with transport to hospitals affected.

http://www.gmanetwork.com/news/video/184157/24oras/binahang-ospital-sa-tacloban-paralisado-ang-operasyon

 

Headed for Tacloban

Our team of four have all arrived in Manila and we head to Tacloban tomorrow. Myself and Joe Harrison from Direct Relief, Dr. Doug Gross from UC Davis, and Jodie Willard our intrepid photographer, are packed and ready to go after getting geared out tonight with tents and water and food rations.

The plan is to set up camp next to the airport with Team Rubicon, the group of military veterans we've worked with in previous disasters, and then make our way to Tacloban City, about 13kms from the airport. The word is that while food and water and medicine are still hard to come by (a local official said that the first resident died from hunger today) transport around the city is even harder. We're hoping to catch a ride with the US Military or the Red Cross, who we've already provided a large amount of medical supplies over the last 10 days.

It seems that while aid supplies are starting to arrive into the area, they still are having great difficulty getting it out to the local populations. Truck drivers have said they don't want to drive across the island because of looting so there's scenes of helicopters just dropping materials from the sky. We are going to try to make our way to the Divine Word Hospital who have been out of supplies for 7 days but still have patients coming in the doors and not leaving because they have nowhere else to go.

Yesterday we had some great meetings with some amazing folks and made a rough outline of the plan for the week. Information is still hard to come by but we should know a lot more after tomorrow. All I can say for sure is that everyone we've met has been extremely helpful and overly gracious to us. These events always have the strange feeling of combining an awful tragedy with the best that people have to offer.

In the air

We're about 12 hours into the flight and its been dark outside the whole time so it's kinda hard to know what part of the day it is. Feels like dinner time. So when they just handed out this fish meal I assumed that it was dinner but Rico, my neighbor seated to my right, assured me its actually breakfast food.  Delicious

The funniest thing so far on the flight is that the stewardesses are all convinced that Joe (my Direct Relief colleague traveling with me and the guy in the picture in the last post) is the actor from the movie "Sweet Home Alabama." Definitely going to have to IMBD that when we land.  

We've already met a bunch of other folks on the flight going over to help out. A US Air pilot from NYC, some other docs from LA. Nobody is entirely sure what to expect or what they are going to be doing once they arrive. We are all anxiously glancing over SitReps and maps and pressing each other for any new info. 

Already, the generosity from some of the Philippinos we've met has been amazing...and we haven't even arrived. After the alarm bells stopped ringing and TSA had finished frisking me because I accidentally put a pocket knife in a checked bag that they told me to just carry on, the TSA agent (a Filipino) escorted me back to the check in counter where the manager (a Filipino) took the knife and told me to call him when I landed back in LA. But when we were boarding the plane, he met me on the jet bridge, gave me the knife, and they checked the bag below so I'd have it on arrival. Thankfully, now Ill still be able to open all the cans of tuna I packed with my sweet corkscrew...

The hard part about packing for this trip is that we really don't know what to expect when we get there. I have a suit for potential high level meetings in Manila and in another bag I have a pound of trail mix, tuna, MREs, water filtration systems, a sleeping bag, GPS locators, and some bug spray with 100% deet that my dad gave me and I think is illegal in the US cause it might actually just burn your face off.

Gonna be interesting...

Locked and Loaded

On board to Manila after lots of fanageling about excess bags and fees. 

Arrival time in Manilla, 4am Sat. Pretty much means Friday is totally lost in the ether. I hope nothing cool was gonna happen that day...