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HOPE works in more than 35 countires worldwide. Please enjoy our blog as we document the successes and challenges of our work to provide Health Opportunities for People Everywhere.
Posted By: Allison Shelley on December 10, 2013
Olivia Glory was not far away when the church collapsed. From her home on the next hillside over, she could see it from her front windows. It was a small building, maybe 15' x 30', and so new that it had not yet received a coat of paint. But it was cinderblock and to her husband Roberto Glory it seemed like the safest place to take refuge as typhoon Haiyan approached on November 8.
But while Roberto sheltered with the couple's children in a neighbor's concrete house, the strongest storm to ever make landfall in recorded history roared directly through the tiny rural farming town. Winds clocked at over 160 mph sent roofs flying as flash floods took out bamboo homes in minutes. Because the winds hit low to the ground, even the smallest shrubs were uprooted.
The little Catholic church collapsed, crushing Roberto and his eight-year-old nephew, who he had been cradling in his arms. The boy died immediately. Roberto was conscious but bleeding heavily. Olivia could hear his screams from the neighbor's home. But because the roads were completely blocked by fallen trees and live power lines, he never made it the few miles to the hospital. Roberto passed away within sight of his home.
The Philippines is the most-exposed large country in the world to tropical cyclones, but this one topped them all. According to the U.N., about 11 million people were affected. The national casualty count has been estimated at over 5,700, making it the deadliest ever. And the Philippines' National Disaster Risk Reduction and Management Council estimates over $800 million in damages in the country.
While the worst of the destruction centered on the more urban Tacloban, where the storm passed first and more fiercely, the Tapaz area, on an island just west of Tacloban, was also nearly flattened. Project HOPE targeted the Tapaz region because it had not yet received international relief.
The first round of HOPE volunteers, who began arriving last week, have been greeted with warm appreciation that has been unabashedly public. Professionally painted signs began popping up around town within days of the volunteers starting their work in the hospital and clinic: "Welcome Project HOPE and thank you!" read one. On Sunday, two hundred children and a clown attended a special "giving thanks" party hosted by two prominent local families, the Arcans and Samaniegos. Members of the family confirmed that there has been no international medical NGO help in the area for at least the past 30 years. On the gate in front of the home a new banner had been hung. It read, "Thank you volunteers from all over the world. We will never forget you. --the people of Tapaz."
Posted By: Allison Shelley on December 9, 2013
The patient was an older man, the size of a teenage boy, but with a deeply etched face, the color of the muddy Panay river the day it so recently swallowed many of the local rice fields. The patient had a mouthful of teeth reminiscent of the newly broken, jutting mahogany trees that littered the surrounding hills. He had weathered typhoon Haiyan, but this was not his first visit to Tapaz District Hospital in recent weeks. Today he came complaining of dizziness.
It was one of Dr. Todd Holzman's last patients of the day. The Project HOPE volunteer, a child and adult psychiatrist, is no stranger to global health. He juggles a consultancy in global psychiatry at Massachusetts General Hospital, a private practice in Cambridge, Massachusetts and regular volunteer medical missions with his wife Terry. It had been a while since he had had this kind of clinical load, but Holzman was still feeling good.
He talked with the patient about his symptoms and then asked him directly, "So, what are you here for?"
"I'm lonely," the man admitted.
"I learned that his wife passed away two years ago-- they had been together for 50 years. His son had also died young. And he was living with a host of medical problems," recounted Holzman.
As he described it, suddenly the nurse in the room chimed in and began suggesting things that the patient could do to become involved in the community. By the time the exam ended, all three were laughing and cracking jokes.
Holzman's gentle way of drawing out his patients has endeared him to them. In the few days he has been on the ground in Tapaz, he has already earned several telling nicknames, including "Santa Claus" and "the priest."
"I didn't know whether I was going for a check-up or confession," one patient remarked to Project HOPE volunteer Seth Tate after being seen at the local clinic by "Dr. Todd."
Years of experience with patients in emergency situations has also given Holzman a sharp understanding of what might be going on in a person's mind after a traumatic event. As Chair of Disaster Services for the Massachusetts chapter of the American Red Cross when the September 11 attacks happened, he helped to coordinate the family support operation that was set up at Logan Airport. Recently, in the wake of the Boston Marathon bombing, Holzman's private practice filled with victims and first responders in need of counseling.
"After their first needs are met-- safety, food, dry clothes, etc.-- people want to tell their story," he said.
Back at Tapaz District Hospital, Dr. Todd organized a special session for employees for precisely that purpose. A skeleton staff of a half-dozen had been tending to the needs of the 20-odd patients on the day of the typhoon-- which passed directly through the rural town less than four weeks earlier.
"A person's experience is usually kept quiet and personal within each individual. But during a disaster, whether it is a mass casualty event like a typhoon, deadly disease or war, or an individual one such as cancer or a car crash, everyone goes through the same things: a sense of total helplessness, hopelessness, being alone, and being at the mercy of the situation or a person that has no mercy. That's the common denominator," explains Holzman. "The antidote for that is compassionate human contact. Someone who genuinely cares and wants to hear your story."
The room was packed. When Holzman asked how many of them had experienced the feelings he described above, everyone raised their hands. Many of those who had been working at the hospital on the day of the typhoon stood and spoke in quivering voices of terror, faith, strength-- of comforting patients as they moved them from room to room while the roof overhead disappeared piece by piece and then of anxiety-- of their own flattened homes-- reached by wading, climbing, chopping.
When it ended, the room was still full and almost no one had taken more than a sip from their Coca Cola bottles. Someone began singing a song about smiling through tears and others joined in. There was hugging.
"You don't have to study in Vienna to figure out what's going on," said Holzman. "You just have to listen and sincerely care, and people respond to that. They feel that they're no longer alone, which brings that sense of community and commonality."
Hospital chief Dr. Jean Aposaga Gloria closed the meeting by thanking Dr. Todd, admitting that "it has made us all smile and feel lighter."
Holzman underscored the importance of such meetings in a place where resources have been stretched thin. "They are caregivers. You can give them antibiotics, a blood count machine-- and that's good, really important-- but if you can help make them more durable, more resilient, then you are giving the gift to their patients of someone who is there for them."
"Everybody wants to help-- this is a way of helping. It's a drop in the ocean but it's OUR drop."
Posted By: Fred Gerber on December 8, 2013
As one group of 17+ volunteers continues providng care and delivering medicines around Tapaz in the Philippines, a second group of medical volunteers, lead by volunteer Dr. Joyce Johnson, HOPE's volunteer Medical Director, is busy working on Camotes Island, another region badly impacted by Typhoon Haiyan.
Team two is working closely with the local Department of Health Immunization Outreach group, aggressively going out to remote population centers to immunize children against the measles, mumps, rubella virus and polio. The team also issued Vitamin A supplements to children in the disaster affected areas.
Posted By HOPE Volunteer Medical Director in the Philippines, Elizabeth Harrell, RN on December 7, 2013
Yesterday was another meaningful day volunteering in the Philippines. Our nurses assisted with the care of a 29-week old baby/premature and requiring an IV. A lot of training and discussions on ethical decisions occurred. The stress debriefing was very well received by the hospital staff and was very timely. It caused some intense emotions and was greatly appreciated.
A family who is from the Tapaz and now living in San Diego is providing a Christmas party for 250 local children. They are so appreciative of what Project HOPE is bringing to the community that they have invited the volunteers to enjoy the party.
Posted By: Allison Shelley on December 6, 2013
"Lord, if you want to take me, I am ready," social worker Melicar Flores recalled praying during Typhoon Haiyan as she tried to protect patients at Tapaz District Hospital-- in the direct path of the super storm. As the corrugated metal roof was torn away from the aging cinderblock building piece by piece, terrified hospital staff spent the day transferring patients from room to room hoping their luck would not run out before the cyclone passed.
Before the wind died down, the twenty-odd patients and five staff found themselves crowded together into the only place in the hospital with an intact roof: a narrow conference room lined with rattling windows.
"Most people thought it was the end of the world," said hospital chief Dr. Jean Aposaga Gloria, whose own home became an evacuation center. "We had about 200 people inside, standing room only."
Both buildings and all of those inside survived, but the structures of the buildings took a beating, as did the nerves of the occupants. Of the twenty patients at the hospital, three were expectant mothers and all delivered the next morning.
A large mango tree fell directly across the main entrance to the hospital, blocking access. Gloria recalls her conversation with the only man she knew who had an available chain saw. She had to promise him extra days pay so that he would give up the salvage work he was doing on his own home in order to clear a path to the hospital door.
"We prepared as well as we could for the storm. The department of public works helped us secure the windows, we tied lose things down. But we didn't think that we'd have to cut down the trees nearest to the hospital."
"They said it would be the strongest typhoon in the world. But we didn't appreciate what that meant."
Gloria describes victims with lacerations from glass and trees, deaths by electrocution from fallen wires, and very little outside help.
Even before the tragedy, things were tenuous. "It's an old facility. Often the repairs are financed by our staff. Nurses are often contributing to things, like repairing tiles. These same nurses are paid only 145 pesos a day (about $3.50)," says Gloria.
The facility has 25 beds, but frequently has 40 - 50 in-patients-- and most cannot pay. "This hospital is a hospital that survives on donations."
The hospital's emergency request for 200,000 pesos ($4,650) for roof repairs from the government has been approved, but the governor's office has said that its emergency funds have been depleted to the point that it is currently not able to fulfill the request.
"It's the manpower that Project HOPE is providing that we really need," she says. Project HOPE has been assessing the needs of the hospital and is beginning to work with the staff to relieve the pressure.
"Our employees are severely overworked and stressed out," says Gloria, describing how those on duty the day of the typhoon had to remain working for three days because the next day's staff couldn't make it through the debris-filled roads and paths to work. "Ten of our employees had completely destroyed homes. Everyone had some damage. All of them are victims yet still have to perform their duties and somehow cope."
She ticks off the priority list for the near future: antibiotics and other emergency medicines, counseling and public education on topics like hygiene and infection control, windows, paint…
Gloria stops, but she is smiling. "We are so grateful that you are here."