After 'Pablo:' Water and sanitation a rising concern

In the wake of the disaster and current state of water and sanitation, outbreak of diseases
is closely being monitored
______________________________________________________________________________
Ana P. Santos
Published 8:15 PM, December 22, 2012
Updated 10:29 AM, December 24, 2012

DAVAO ORIENTAL, Philippines Aid agencies and national government are scrambling for normalcy in
the midst of massive destruction wrought on healthcare facilities by Typhoon Pablo.
About 18 days after the category 5 super typhoon pummeled the southern part of the country on
December 4, the healthcare facilities in Cateel and Baganga remain without electricity and erratic water
supply.
The roof of the hospital was blown away and we lost almost everything -- hospital records,
equipment. I would say about 85 to 90 of the hospital has been damaged and our roof totally destroyed,
said Dr Dante Enriquez, chief of the Cateel District Hospital.
We use generators for electricity, but we turn them on only at night. Our two sources of water: the
municipal water district and the deep well system have been damaged. The pipe to the municipal water
district has been cut and the motor to deep well needs electricity to run, said Enriquez.
Enriquez is one of the two doctors on staff at the Cateel District Hospital. While tending to
hospital work, he also has to cope with the effects of the disaster. My home no longer has a roof, too. We
lost nearly everything, too, he said.
Overwhelmed
Typhoon Pablo, classified as a Category 5 super typhoon made landfall 3 times, sweeping through
the coastal area of eastern Mindanao, reducing agricultural fields in its path to wasteland.
According to the latest report by the National Disaster Risk Reduction and Management Council
(NDRRMC), Typhoon Pablo affected an estimated 6.2 million people and left damages to property
totaling P34 billion.
This area is not used to being hit by typhoons and the materials used to build homes and
buildings were not very strong to begin with, explained Roman Rhienhardt Ladaw, water and habitat
engineer of the International Committee of the Red Cross (ICRC).
According to reports, the last time that a storm of this magnitude hit the area was 1912 a hundred years
ago.
The ICRC is working on rehabilitating the water pipe system of the Cateel District Hospital so
that it will have an adequate water supply for wash and sanitation purposes. The pipes of the hospital
have a lot of leaks so water is wasted. We need to make the water supply more efficient.

To augment the hospitals supply of potable water, the ICRC has set up a water treatment unit
which can filter water at a rate of 8,000 liters per hour and can be benefit up to 400 people at a time.
A similar water treatment unit was set up in the Cateel municipal hall so the residents would have
continuous access to potable water.
Last 13 December, the ICRC launched an appeal for US$10.8 million (P4.4 billion) to scale up
emergency response efforts.

Make-shift medical care facilities

In the municipality of Baganga, where Pablo first made landfall, primary healthcare for its more
than 53,000 population was provided by the Regional Healthcare Unit, which was also severely damaged.
The residents of Baganga now have to depend on the Cateel District Hospital, further
overwhelming them, said Lt Col Krishnamurti Mortela of the Philippine Army who is heading the
Incident Command Post in Baganga.
 Some people dont even go to the hospital anymore because they are too far and dont have
money for transportation, added Mortela.
Neldy, a 43-year-old farmers wife, has been nursing a gaping, crusting wound on the top of her
head. Hindi ko na alam kung ano tumama sa akin, (I dont know what it was that hit me), she said,
describing the wildly howling wind that brought with it coconut trees, debris and corrugated sheets from
rooftops.
She was given a painkiller during a medical mission visit. Hindi na daw ito matatahi kasi
natutuyo na. (The wound is drying and can no longer be sewn up.) She has no means to go the hospital
for additional medical assistance.
The Philippine National Red Cross (PNRC) has set up an emergency medical post using tents
near the Baganga gymnasium, while the Department of Health has converted an old office in the DPWH-
Baganga compound into a treatment unit.
Other aid agencies and NGOs have been sending medical missions to reach out to residents who
do not have the capacity to travel to health facilities.
The challenging conditions have posed limitations on the medical services that can be offered.
We can only treat limited cases here like minor wounds, cough, colds and diarrhea. We have to
refer other cases to the Surigao Del Sur Provincial Hospital, which is 3 hours away. For extreme cases, we
have made arrangements with the Philippine Army to airlift patients to the nearest hospital using a
helicopter, but that is subject to weather conditions and only in the daytime for safety reasons, Jay-Ar
Cristobal, PNRC national field health representative for Mindanao, said.

Ailments
In the wake of the disaster and current state of water and sanitation, outbreak of diseases is
closely being monitored. But this too has been difficult because the healthcare facilities do not have
diagnostic and laboratory equipment available.
We had one death [two days ago] possibly from infectious diarrhea, and have recorded 93 cases
of leptospirosis since the storm, but we cannot tell for certain, said Dr Renee Faldos, DOH provincial
health team leader for Davao Oriental.
Leptospirosis is bacterial disease brought about by exposure to water or soil infected by the urine
and feces of rodents.
We are only able to do what we call syndromic diagnoses. We check if a patient exhibits 3-5
symptoms of an illness, but cannot confirm because we have no laboratory equipment to make a
confirmatory diagnosis, said Faldos.
The Japanese Red Cross has seconded a rapid deployment basic health care team to provide
immediate basic curative, preventative and community health care to the affected population, reinforcing
the PRCs medical response already on the ground.

Last December 8, President Benigno Aquino III put the entire nation under a state of calamity and
instructed national government agencies to ensure that electricity is restored in the villages before
Christmas. - rappler.com

https://www.rappler.com/move-ph/18421-after-pablo-water-and-sanitation-a-rising-concern