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Offering Hope in the Midst of Disaster

Disaster relief work in the Philippines

"The first thing I noticed about her was her beautiful, infectious smile. Her tidy white hair and pretty yellow dress lent her an air of joy and graciousness. I never would have guessed that this sweet old lady had just lived through the worst storm in known history and lost every single earthly possession to her name. My mind was flabbergasted that in the face of so much loss and suffering, this woman had such a cheerful heart. Her illness was simple; a few body aches and uncontrolled hypertension from no access to her regular medications, but her cheerful heart was good medicine to my weary, sweaty and overwhelmed soul (Proverbs 17:22). As a former missionary kid and now missionary nurse with 21 years in the Philippines, I never cease to be convicted by the gratefulness and resiliency of the Filipino people. Yes, a short conversation with any of the survivors will bring about heartache and tears, as recovery will take decades, but I left Tacloban with a full heart and a healthy lesson to ‘give thanks in all circumstances’ (1 Thessalonians 5:18a)."
— Pami Ellis, a missionary nurse serving in the Philippines

by David Stevens, MD, MA (Ethics)
Today's Christian Doctor - Spring 2014

We were wasting fuel as our turbo-propped Cebu Pacific plane circled and circled while waiting to land. The military traffic had priority, but after 15 minutes our plane, with more than half its seats empty, straightened out for its final approach. Few wanted to go to Tacloban, the largest city on the Philippine island of Leyte. While everyone who could was trying to get out, we were anxious to land.

I glued my nose to the window as the ground approached. Road graders and bulldozers, previously air-lifted in, had pushed mounds of debris to the side of the damaged runway on a peninsula that itself had been bulldozed by a 15-foot storm surge. The arrival terminal was missing every window and most of its high roof, victims of the vicious winds. Some of the concrete beams holding up the structure were badly damaged.

As I came down the plane stairs, U.S. Marines were unloading bags of rice and other food from the gaping tail of a C-130, sweat running in streams off their bodies. A light rain took the high humidity to 100 percent and the temperature was about the same. Within a minute, my pores opened. I wouldn’t stop sweating until I got on a plane to leave more than two weeks later.

At the door to the terminal stood two Salvation Army officers in crisp white shirts with shoulder epaulets. They ushered us into vehicle with a van-like front and an enclosed truck-like back. After loading our luggage, we climbed in and sat on benches along the side as we wound our way through the debris piles during an hour-long trip into town.

Words cannot adequately describe the destruction. Once majestic 100-foot coconut palms were either uprooted or snapped in two like twigs. As we got to the edge of town, most buildings as far as you could see had been leveled. The walls of countless concrete block buildings were blown down by either the 200 plus mile an hour winds or the power of the wall of water. Even buildings with reinforced concrete walls hadn’t been spared.

There was a sickly sweet pungent odor of rotting bodies. Dump trucks parked on the side of the road were being filled with black body bags as we drove past. When Typhoon Haiyan (Yolanda) hit on November 8, 2013, it became one of the worst recorded storms in history, killing more than 10,000 people and leaving millions homeless. Looking at the devastation, it was hard to believe anyone survived. Workers would still be collecting bodies from the rubble when I left 18 days later.

At the invitation of and in partnership with the Salvation Army, CMDA sent its first Global Health Relief team to help address the enormous health needs generated by the scope of the catastrophe. I was leading a small exploratory team made up of Steven Euler, a young former Air Force internist working at Christ Community Health in Memphis, Tennessee; N.T., a missionary family practice physician serving in Egypt; and my brother Paul, who served as our photographer/logistician. We planned to pave the way for other teams to come.

As darkness shrouded the city without electricity, we arrived at a small Salvation Army Corp (church) just off the Pan Philippine highway in the north part of the city not reached by the storm surge. It was headquarters for all their relief efforts, and it was crowded. We met Filipino staff members and disaster specialists from the Salvation Army’s international headquarters in London, while simultaneously reaching for our insect repellent to fight the clouds of mosquitoes carrying Dengue and Japanese Encephalitis. As we ate rice and vegetables under a tarpaulin and tried to talk over the noise of a small generator powering a few lights, I wondered where we would hang our mosquito nets and lay out our camping pads. There obviously was not enough room in the church building for the 30 people there, even before we arrived.

"This trip meant obedience since I wasn’t planning on going. Just got a small nudge inside ‘to go’ when I first heard the news about the disaster. One day later, I got an email from a friend of mine that asked me if I could go—this to me was the confirmation I needed from God. I purchased the tickets and was on the plane within three days. It also meant that I would face many unknowns with little time to prepare. Some of which included the thought of many dead or dying people or still uncovering survivors from under the rubble that could have so many needs from polytrauma to PTSD, etc. Fortunately, many of these fears were not realized. Our team had an opportunity to give medical care to a number of patients from pediatrics to geriatrics. My hope is that through the care that people received they would know of Christ’s love and care for them and that follow-up with local Salvation Army and other churches would happen to share the True Cure and Hope."

— N.T., a missionary family practice physician serving in Egypt

After supper, we carried our luggage down and across the street a few houses to a damaged unit of a two-story triplex they had rented that day for the overflow. It had three rooms upstairs and a large room downstairs. The larger room had served as a combination living, dining and cooking area in better days, but there wasn’t a stick of furniture in the house. As our flashlights shined in the door, the biggest roaches I have ever seen ran for their crevices. Their presence prompted a word of caution from one of the Filipino staffers, "Make sure your mosquito net is closed. These roaches like to bite sleeping people in their eyelids!" It was probably for the best that I didn’t realize that these roaches wouldn’t be our biggest problem.

We did have "running" water. Well, kind of. A Filipino teenager was hired to bring buckets of water from the "well" in the small courtyard. It was about three feet down to the shallow water and only about eight feet away from the drainage ditch full of refuse flowing down the side of the road. I learned to take a very fast "shower" by candlelight with a dipper and bucket, all while making sure to keep my mouth shut because the water was swimming with amoeba.

The four of us strung a cord to hold some of the mosquito nets up, stripped down to our shorts and packed ourselves into a small room, side by side. Thank God for Ambien or I wouldn’t have slept at all in the humid heat. Even with its sedative effects, your body woke you up throughout the night to drink water to replace what you were constantly sweating away.

With little real rest, we got up as sun poured in through the broken window at 5:30 a.m. and soon headed to the other side of the island to the smaller city of Baybay. In its daily health cluster meeting with health-focused relief organizations, the Ministry of Health asked us to help at the city’s district hospital. The 55-mile trip took us almost five hours; when we arrived, we found a Chinese hospital ship had pulled up to their port the day before and 40 doctors disembarked and usurped our assignment.

So we traveled to the local corp and held an impromptu clinic at the church, seeing around 50 patients before darkness fell and we got our sleeping pads out for another restless night. There were a few acute injuries, but people were suffering from chronic diseases, including a large number with undiagnosed severe hypertension. Systolic blood pressures of over 200 were common in thin people with a high salt diet.

In the morning, we headed back to Tacloban, stopping along the way to see if there were needs at a couple of hospitals. It soon became clear that most of the large relief groups, many sent by governments, had deployed along the main highway.

We ultimately ended up back in the same house in Tacloban, and it became our base from which we traveled out to small villages far off the road to see patients. Almost no one was working in these needy areas where people had lost local transport to get to the towns for medical care. What transport was available had quadrupled in price and, even if they were able to get to town, local pharmacies were damaged and closed.

"Today in our clinic I had the opportunity to care for Maria, a 10-year-old girl with an abscessed tooth. She had been in pain for about a month. She lost her mother and father in the horrendous typhoon. Her aunt, whose home was destroyed and lost her two sons in the typhoon, has taken her in and they are living in another sister’s home. Maria was so thankful to have her tooth removed she gave me a kiss. What a tragic story for such a young life to experience. We prayed with her. There isn’t a family that I have met since I have been here that hasn’t been touched in such a horrific way. The Salvation Army has been wonderful in their grief counseling and spiritual ministry—they spent over an hour with this family alone."

— Sam Molind, DDS, from a blog post written while serving in the Philippines in December 2013


We linked up with local midwives who got the word out and helped us set up clinics in rural health centers and schools among the rice paddies and shattered coconut groves. Our team was joined by two invaluable members: Pami Ellis, a missionary nurse raised in country and fluent in the local language; and Russ Villanueva, a young American-Filipino missionary doctor who was bilingual. Pami did triage getting vital signs and some history, while Russ ran the pharmacy explaining medicines, giving treatments and sharing the gospel. We were soon seeing around 60 to 100 patients a day.

Every single one of our patients had lost something—most had lost their homes while others had lost their coconut trees which will take years to regrow. Their banana groves were flattened and much of their rice crop was gone. Yet, I was amazed at the resilience of most of the people. When I commiserated with their losses, the usual response was, "Yes, but no one in my family died." Unfortunately, that wasn’t true for everyone.

We saw a grief-stricken grandmother run bare breas-ed while wailing through the airport. She lost all six children and 20 grandchildren in the tidal wave. One patient still vividly sticks out in my mind. When he first arrived, he was trembling so horrifically that I assumed he suffered from Parkinson’s disease. But after completing a medical history and exam, it was obvious he was still shaking with fear two weeks after the typhoon. He couldn’t sleep. He could hardly eat. He lived in mortal fear of another storm. I gave him something to help him sleep as well as some counsel, but realized his need was much deeper than I could address through a translator. Russ pulled him aside in the pharmacy for more prayer and counseling as I turned to my next patient. I glanced up a while later as the man left the clinic, and he was no longer trembling and there was a smile on his face. Russ’ joy was reflected on his face as he related, "He accepted Christ. He is a new man."

The power of God is greater than any typhoon!

Our partnership with the Salvation Army was God-ordained. Their pastors prayed with patients, provided counsel, drove us to our clinic sites and helped handle all sorts of logistics. It freed us up to do what we do best. We gave talks explaining how to use the hygiene kits they were distributing in the communities. We participated in the World Health Organization’s efforts to give Vitamin A as well as measles and polio vaccines to all children under the age of five. We immunized hundreds of children. As other CMDA teams sequentially arrived, we added dental services, something no other group was offering.

As basic health services in the country began to come back online in mid-December, the Ministry of Health asked relief groups to wind down their efforts. Just after Christmas, the last Global Health Relief team left the country knowing the Salvation Army’s efforts to help the people on Leyte and other islands to rebuild their lives will continue for years.

On my way out of the country, I met with national and international Salvation Army leaders in Manila. They are enthusiastic about a continued partnership jointly responding to disasters together around the world. Pre-planning for a quicker response next time is already underway for CMDA to have someone on the ground as soon as possible to establish where we can have the greatest impact with our abundant resources of physicians, dentists, nurses, pharmacists and other healthcare professionals.

Why? Because that is what Jesus would do. He met individuals at their point of catastrophe and ministered to them. As He told the story of the Good Samaritan, He taught us that our "neighbor" is not the person living in the house next to ours but everyone in need. Though we are busy with our daily lives, we should inconvenience ourselves and respond when we see the need.

Christ doesn’t pull any punches about being first responders. It is uncomfortable and risky. It costs everyone something. Our team missed Thanksgiving, while others missed Christmas with their families and friends. All of us lost significant weight in the sparse living conditions. Some endured bouts of diarrhea and vomiting.

After we had been in our house for a week, we had an invasion of rats seeking food. One of our national staffers awoke with a rat biting him in the foot as he slept. After that, all of us slept with one eye open each night. We couldn’t get a decent rat trap in the country, so we endured until some arrived from the U.S. with the next team.

Yes, it was rough, challenging, draining and dangerous. Going where Jesus would go and doing what Jesus would do almost always is. But I wish you could see people’s smiles and hear their heartfelt "thank you’s" just because we cared enough to come, to care, to treat, to pray and to be Christ’s hands and feet. And some patients found more than that. They found Christ as their personal Savior.

God doesn’t waste tragedy. He redeems it and uses it to make Himself known. In a much bigger way, He did that for the entire world. So we go, as He did from the comforts of heaven, to people in desperate need to show them in a very practical way that God loves them.

Maybe next time a disaster happens you would like to join us by praying, giving or going? There is nothing more fulfilling that seeing God work through you.

Are you interested in getting involved with Global Health Relief? Visit www.cmda.org/ghr for more information.

 

 

 

"We drove to the town of Calipayan today which had no medical care before the storm except for an hour away. When I say no medical care, I mean not even a Tylenol or Advil tablet available. (When the storm hit), everyone in the community went to the school which survived the storm other than the loss of the roof on some buildings. Every home was destroyed there even though it was inland. I heard that two other groups are pulling out this week, so there will be very little aid help by next week. As we drove through Tacloban, I kept seeing signs saying ‘TINDOG TACLOBAN!’ At first I thought this was some dude buying scrap, but then I found out it means ‘STAND UP TACLOBAN!’ As we went through the city, there were thousands of concrete houses with collapsed roofs, walls caved in, sometimes only a small piece of foundation left, or at times you would see the front of the house missing and then the back of the house buckled out and bowing from the force of the water hitting it. Some of the locals said many were killed not only by drowning but by debris penetrating their bodies. I remember as a child someone bringing a 2X4 to school with a piece of pine straw penetrating through the piece of wood with such force that it did not even break the pine straw. We have to remember this massive typhoon was essentially a class 3-4 tornado. At the village where we have been, the people are smiling and the children are happy and playing. People ask them, ‘Why are you smiling?’ They say, ‘We’re alive and are thankful.’ The sermon this morning was 3D: 1) Divine warning; 2) Divine promise; and 3) Divine dwelling. The people here have one room to cook, eat and sleep in. But they have the assurance of a Heavenly Mansion in the future and that keeps them going and happy despite the loss of everything."
— Tom Sanderson, MD, from blog posts written while serving in the Philippines in December 2013

All photos courtesy of Paul Stevens © 2013.


ABOUT THE AUTHOR

David Stevens, MD, MA (Ethics)