Team 5 - the last days

06.01. Monday

Today I go to Tacloban and Palo with Mark. We buy food and several other things; in Palo I buy some missing medicine. We need acetaminophen syrup, for days the number of hyper pyretic toddlers has increased. I also buy antibiotic ointment since we continuously see infected wounds. I don’t buy gloves because they are nearly as expensive as all drugs together and they don’t have enough gloves anyway.

After 3h rattling and high stress for our respiratory tracts due to smoky fires next to the street, we arrive at the camp and have lunch. We have MRE, for me salmon salad, fruits, rice cake and coffee.

At 2 o’clock Florian, Ralph and I set off to Dulag to support the Nurses and Midwifes. We are already expected by about 50 people, we will be able to treat 20. We take Emilie with us. She is 13 years old and has an infected toe. The nail needs to be removed and the wound cleaned. Emilie stays with our interpreter and comes for the surgery the following day. A small boy with an hand injury had to come the following day as well.

At 5.30 we are back at the camp. Our respiratory tracts are highly stressed and Florian stays at the camp this evening because he has almost no voice. The rest of us go to Papos, the mayor or better the voluntary municipal administrator. He invited our team for dinner as a thank-you.

Papos tells us touching stories about the typhoon. He himself lost his father, as well as numerous relatives and friends. The typhoon in itself was not the problem, but the following tsunami brought many victims and destruction.

He doesn’t really want the tents of UNHCR. He says that they make the people lethargic. He would rather like money for building material. The people should build their own houses that are more stable and continuous.

07.01. Thursday

Yesterday our container arrived and waits to be filled. Slowly we really need to say good-bye.

We ask the midwife if she is interested in our medicine. She is keen to come in the afternoon to have a look at everything. Together we look through the Health Kit. She is familiar with the content (also the medicines). She could also use the infusion solutions and the tetanus vaccination. I have a good feeling and we agree to bring her the medicines on Saturday. She is going to distribute the medicines to other delivery wards and to the hospital in Tacloban where they have a great lack of medicines as well.

The midwife has several students who she hopes to study medicine later. We agree that 2 of them come to us for a training with the medicines. We are going to try to set up a pharmacy with our medicines at the delivery ward on Saturday. The midwife and her helpers will be in charge of this pharmacy.

Today you can feel a spirit of optimism in San Joaquin. School has started, Christmas time finished on 6.1. and nearly 3 months after the typhoon the people start to increasingly tidy up and to work.

So I am looking forward to a good completion of our work here. While I was sad in the beginning that I was part of the last team that breaks camp, I now see a positive development.

09.01. Thursday

My „students“ turn up on time. They are highly motivated and are looking forward to their work. We talk about the basic medicines. They can deal very well with the Essential Drug List. They are able to find the medicines in the book and the originals and we talk about the usage, dosage and intake.

When patients come from the medical tent, Hannaj, Glenn and Felmark give the medicine out and take record independently.

After a long lunch break (48 degree!!) I explain the stockcards to the students. We want to have a card for every drug when we set up the pharmacy for Joy on Saturday. We start with the copy the stockcards at a cooler place, so that we only need to add the amounts on Saturday.

10.01. Friday

In the afternoon I was in Dulag with Florian, Lisa and our students. We have 20 patients; some changes of dressings, some fevers, cough and cold, older patients with very high blood pressure. We take one girl with us in the evening in order to operate her down to the bone festering finger. Glenn explains a salbutamol spray to an elderly, asthmatic women and it turns out that she already has one at home. It has not helped her so far since she did not know that she needs to remove the cap of the mouthpiece. Again you see how important pharmaceutical care is!!

11.01. Saturday

After lunch break we start to move the pharmacy. The cupboards are finished. We have 2 tables, 2 daybeds and medicines, bandaging material and infusions solutions. I hope that the rain stops in the afternoon, at the moment it rains so heavily that after 1-2 minutes in the rain everything is completely soaked. At the moment we cannot think about striking the medical and pharmacy tent.

The joy of the people here really gives us food for thought again and again. We never hear anybody complaining, everybody tries to take the day how it is and simply is glad to have survived. But there are also other moments. Lisa gives Ed, one of our interpreters, one of our stuffed animals for his little sister. He is delighted and names the rabbit Eve. Lisa asks him why Eve. After a while he tells us (obviously really moved) that today would have been the birthday of his mother Eve who lost her live at Jolanda.

Sunday 12.01.14

The priest invited us to curch today. In the beginning he mentions already that we will soon depart to help at other places. The choir sings wonderfully. In his sermon he thanks as again for our work. While preparing for the Holy Communion, Papoose comes to us and tells Lars and me to carry the bread and the wine to the altar. An honor – but he surely did not know that we were more or less the only Protestants in his church.

Team 5 – report of Michaela Spoettl San Joaquin 01.01.-15.01.2014 – part 2

3.1.

Arrival in Tacloban at 7 am. Already with the landing approach we see hundreds of tents that stand between the destroyed houses and snapped palms. Water is everywhere. It is us and local visitors in our plane.

After a very uncomfortable landing we are welcomed by the NAVIS team leader on site. We take our luggage and are on our way to the camp in a colourful taxi. We are anticipated with joy. The efforts of the last weeks are written all over the team’s faces. They are looking forward to home, but are sad about the farewell as well since they all had touching experiences and new friends in the local population.

We start with the handover and briefing because the departure of team 4 is already in 3h. We are introduced to a perfectly managed and well equipped pharmacy. We also move into our sleeping tent, visit the kitchen with fridge which also contains our vaccines and get told to put absolutely no paper in the toilet. The toilet is the only leftover of a house. The shower is built from pallets, we are looking forward to using it in the evening. It is comfortably warm but very damp; we have the feeling to “leak”. This is why we are very glad about the NAVIS-water (although the taste needs getting used to)

We get a first impression of the weather. It starts to really bucket down. In a second the rear ground of the pharmacy tent is wet, before we manage to close the tent.

We pharmacists and Florian, our doctor, go to the Midwifes, an US organisation that offers prenatal care and delivery as well as basic medical care for free. We will come here in the afternoons to offer physician support. After a visit to the Spanish Red Cross (we are impressed by the sunken forlift) (they produce water for the population here and give it away for free) we return to the camp, where the departure of team 4 is about to happen.

Farewell from the mayor, last commemoration with candles at the communal grave of the church and team 4 is off to the airport.

We start with our work straight away. In the medical tent there are several cuts, infected wounds, feverish children, cough and cold as well as asthma. We handle our work easily. The teamwork with the doctors is very good. The interpreters are very dedicated. Nelson will leave us on Monday. He is teacher and on Monday school finally starts again for the children.

Lisa, our medical student, helps eagerly. She worried that she would not be able to help, but besides changing dressing, aspirating syringes and other tasks she gains insight in sewing wounds, ultrasound, auscultation, vaccination etc.

Again and again people thank us. The children are very communicative, they sing, play, get water, sit with us and surprise us with “Play with me”.

At 6 pm we finish our work. Ravenously we eat our French MREs with appetite; rice with tinned salmon and mini cheese fondue is my dinner. Claudia enjoys cold tuna salad. After that, we sit together with a cool beer, at 8.30 pm I sink in my cot and not even the power generater behind my tent wall can keep me from sleeping.

4.1.

I set my alarm to 7 am, at 8 we want to start work. Since the church bells wake us at 5, I need to realize that I am the last to get to the breakfast table at 6.15. It is already very warm; we prepone our meeting and the men climb on the school roof, as long as it is not yet too hot. Today it is dry, but the sun burns merciless. Everyone needs to put on sunscreen, wear a hat and drink a lot. We already had the first sunburns yesterday although it was cloudy all the time.

While I write here, a girl is operated at her knee in the medical tent in front of me and cries quietly. Although everyone here is very brave, it still hurts and there is also fear. A small cut got infected and needs to be lanced and cleansed. After that the girl gets a Tetanus shot. We register all the vaccinations and hand the data to the Philippine Health Ministry.

There are 40 degree in the medical tent, a great burden for our team. At 10 am I have alredy drunk 1l, my skin is wet and sticky. Fortunately, we have loads of clean drinking water.

Infected wounds are our main problem. Due to the heat and the very high humidity the germs have an easy job.

We give away antibiotics and painkiller. Also antihypertensive medicines. Again and again I look into friendly faces. The people and especially the children trust us blindly and show us their gratitude.

The technical team waits for constructing material in order to continue with the school roof. The heat and the high humidity are nearly unbearable. The children sing us hits. The power generator roars. The locals are in gumboots or flipflops on their still wet properties to tidy with bare hands, shovels and wheelbarrows. Everything from the roofs, that is still left, gets protected and covered with rainproof covers, also with the help of NAVIS. Many built simple huts with planks. The washing (yourself and the laundry) takes place at burst water conduits.

Around noon a small boy is brought who fell from a motorbike. Here the whole family rides on one bike without protective clothing and considering the reckless traffic, I am nearly wondering why there are not more accidents. The boy was quite lucky under the circumstances, other than a few severe bruises and the shock nothing happened. Just hope that the wounds don’t get infected.

Florian, our doctor, Lisa, the medical student and Claudia drive to the Merci-sisters who have built up a delivery ward in Dulag. There are 3 children per day – or better night. Meanwhile the word has gotten around there that there are nurses and a basic medical care on site. This is why we support this work in the afternoons.

Our paramedics and I stay here to dress more patients and give out medicines. I can help with dressing and give out painkiller. At 4 pm everyone is gone. I make coffee for the men on the school roof who have to stop their work as well because it starts to rain again. Florian, the technician, needs urgently to rest; he burnt himself out on the roof in the sun. The drinking water treatment plant still needs to be maintained. Today I am going to cook, since I have time; we have fried vegetables with spaghetti and fruits for desert. In the evening we want to got for a walk together. Anyhow, everyone is looking forward to a shower.

I (Claudia) went tot he Midwives with Lisa and Florian in the afternoon. The drive takes about 30 minutes – the condition of the roads is not very good (they might have not been the best before as well..) and due to the style of driving of our driver we get shaken up even more. He sits quite cool in the front, sometimes I believe, he can’t really look over the steering wheel. The side windows are full with stickers, he sometimes need to open them in order to see if anybody is coming from the side. Everybody honks while driving – Attention, I am coming and I hold my ground!

We are wistfully expected at the Midwives. They told all the patients who need a doctor to come again this afternoon. In the rear part of the tent there are a few women breastfeeding. Among others there are twins and the husband helps his wife breastfeeding by holding the second child to the other breast.

And it is warm again, although it is a white tent. The patiens are meny little children, mostly “cough and cold” – sometimes you can’t hear anything with auscultation. Maybe they just wanted to see our doctor.

A little girl, about 1,5 years old, has distinct asthma, you can clearly hear the stridor. It is supposed to inhale again at the midwives and you clearly see the improvement after that. Another 9-year old girl has no appetite, the urine is highly concentrated and the eye bulbs slightly yellow. After an examination Florian explains the mother that she should go to the hospital with her because it could be hepatitis. Some have asthma. Together with the doctor and the medical student I discuss the therapy. A very nice and yet unfamiliar teamwork. We control some wounds and need to go home although there are many patients left, because it is already dark at 6 pm. Our team misses us already and calls. At the hard shoulders of the street little fire are burning – waste disposal.

I am looking forward to dinner, that is very delicious, because there is no time for food during the day. From time to time a treat or cereal bar help during the day.

Subsequently, we have team meeting and enjoy the evening with candle light. Suddenly a mother comes with her grown-up daughter who suffers from asthma that has escalated psychosomatically since the typhoon. We give her a salbutamol MDI and explain the usage. Se hyperventilates with excitement, starts to collapse and very quickly, yet calmly the medical team give it everything, sedate her a little bit and and everything normalizes again. It is a little bit difficult, because we don’t have all the medicines for those critical situations that the doctors are used to from Germany. With some creativity we still manage the situation. By now somebody got our interpretor Nelson from a party and he can help us to explain everything to the patient and her family.

Our technical team gave out 6500l water today!!

05.01.2014 – Sunday

Michaela and I decided to go to church today. The bells ring only at 6 am not 5, so we can get up later.

As we still have time, I go to the cemetery in front of the curch with Lisa. Children run around, a small boy adjusts the soil on one grave – caring, as if he could carpet somebody.

At 8 am the service starts.

After the service we work in the hospital and the pharmacy again. Like always we need to change many dressings. Coughs become more frequent. But we also have severely sick people. A young man has an inoperable tumor in his head. He can’t feel his right arm anymore. We can’t help him anymore except for giving him remedies for seizures and painkillers. It is endlessly sad to know, that he will die soon.

Team 5 – report of Michaela Spoettl San Joaquin 01.01.-15.01.2014 – part 1

1.1.

Departure of Munich with NAVIS team. At the airport NAVIS members and Thomas Bergmann PSF said us warmly good bye. Spontaneously a passer-by gives money for our mission. The flight with Emirates Airline is very comfortable. Even the bathroom with several fragrance essences resembles a wellness spa. The food is excellent. After arriving in dubai I think about the contrast that expects us soon. The Heineken, that our men treat themselves with, is 12 dollar!! We celebrate Christopher’s birthday with a brought pyramid cake with candle. Because of the time difference he has a very long birthday with 1,5 days.

The chocolate out of camel milk is interesting. There are Swiss precision clocks, jewellery, high end cosmetics and nearly everything the heart could wish for and the purse can afford.

In the departure hall a Philippino gives profuse thanks to us for our help. We are on our way to Manila and the atmosphere changes. In the plane the stewardesses warmly thank us as well. The flight is 8h and we are all very glad to finally move our legs again. We then move them quite extensively because get announced the wrong terminal for our flight to Cebu twice. With “secret paths” we finally get our flight just in time.

2.1.

After repeated controls we are in the plane to Cebu. There we are welcomed by Uwe Polakowsky. After the obligatory group photo we are going to Lapu-Lapu, where we are expected with a delicious dinner and (even better) a shower. We have only 3h sleep left, but we don’t let ourselves disturb by the screeching of the chicken or the truck that fills the newly built pool. We will use the pool on our return.

Uwe is German and has lived in Cebu for 2 years. From the beginning he supported our mission. He took care of the pickup, transport and interim accommodation of the volunteers as well as other transports. We are very thankful for this support and Andreas Portugal gave me a thank-you-parcel for him. NAVI brought him wholemeal flour. Since Uwe misses our German bread, he wants to bake himself. He was very touched and sayed that we didn’t need to thank him. He is just glad that he can help and thinks our mission is great. He has never met so many nice people at the same time before.

In the beautifully made garden there are tame rabbits.

After a good breakfast we are going to Tacloban with the plane. It is only 10 kg luggage per person allowed; we are supposed to pay 500 Euro for all of our excess luggage. Uwe and Lars try to negotiate. We fly; if we need to pay or not, is not yet clear. The departure delayes because there is no power to clean our plane, resp. to drain the waste water. We could have slept longer…

Report Team 3

Team 5 prepares for departure and team 4 is at work in San Joaquin. Susanne Mebes and Katarzyna Ostendorf from team 3 wrote down the following impressions:

Just like our colleagues from team 2 we were shattered by what we saw after our arrival in Tacloban and San Joaquin. It is hardly imaginable how the places look like that were destroyed by the typhoon. Everywhere garbage, destroyed buildings and stench of burned plastic. Only at the end of our stay you could see the green of the new plants in the grey-brown landscape.

The takeover of the work in the camp on Sunday was characterized by great friendship and helpfulness of our colleagues. It was the first aid mission for both of us, Susanne and Katarzyna, so everything was new to us. The training was a good preparation for us, but still the contents of the KIT boxes were sometimes a surprise for us. The previous teams had also purchased many other medicines for the actual demand and we needed to get to know the stock of our pharmacy. We optimized the daily work for us and reorganized the stocks.

The collaboration with the doctors and paramedics from NAVIS was characterized by mutual trust in respective competencies and continuous agreements. Like described by team 2 before, we needed a lot of flexibility and creativity at our work.

The teamwork with NAVIS was great fun. The jointly prepared dinners were delicious every time. The cool hours after that and the conversations in a language we needed to understand first (Bavarian) are unforgettable. Especially the jokes, that we needed to be translated to German.

We won’t forget the omnipresent children with their plays, dances and songs.

In der Erinnerung bleiben auch die allgegenwärtigen Kinder mit deren Spielen, Tänzen und Gesang. From big to small they all romped in our camp as well as in all other camps or mobile hospitals. Their untamed joy of live was contagious.

We also participated in church live. The visit of the mass, which was celebrated by the bishop, and the following banquet were an expression of the enormous hospitality of our hosts. We met this hospitality everywhere. The patients were not only very patient and waited in queue for our doctors and after that for us, they were also always very friendly. Sometimes we all laughed together after we explained the intake of the medicines, especially the usage of metered dose inhalers. The people helped each other when one of them didn’t understand English very well or didn’t understand our drawings on the medicine bags because of lacking art skills on our side.

One thing surely stays in our Philippine memories: the church bell. Its unforgettable sound waked us every day at 4 am. The last days it was accompanied by Christmas carols from the speakers of the church. Many colleagues have a new alarm tone in their mobile phones.

Working on Christmas

On Boxing Day maintenance works were due on the drinking water treatment plant for the first time after several weeks. The technicians had to fix a technical defect on a big NAVIS power generator as well as a burst feed hose for the drinking water treatment plant. This was the one of the reasons why the supply of drinking water was a little less than normal with 3 000 l instead of 4 00 l.

The medical staff had to treat about 160 patients after only 40 patients on Christmas day.

Meanwhile all volunteers of the 12-headed team are well. The atmosphere in the team is still very good, also because the catering became more and more varying because of a better availability of fruits, vegetables and bread.

On Christmas Eve there was a big Christmas service in church which was also attended by the arch bishop. Our team also participated in performing a German Christmas song for the whole congregation. With several talks the representatives thanked NAVIS and PSF Germany for their help in San Joaquin. Finally the whole team was invited to a great joint dinner. Unfortunately not all team members could attend the dinner due to illness. With temperatures up to 40°C and extremely high humidity some volunteers need a break.