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Pneumonia Is New Threat to Storm-Battered Philippines Pneumonia Is New Threat to Storm-Battered Philippines
(about 3 hours later)
TACLOBAN, the Philippines — Two weeks after Typhoon Haiyan devastated the east-central Philippines, a new problem has emerged: pneumonia.TACLOBAN, the Philippines — Two weeks after Typhoon Haiyan devastated the east-central Philippines, a new problem has emerged: pneumonia.
Hundreds of thousands of people have lost their homes and are living under tarpaulins and in makeshift huts across Leyte Island and nearby islands. These simple structures are proving no match for torrential rain and a rapid alternation of chilly breezes and sweltering heat.Hundreds of thousands of people have lost their homes and are living under tarpaulins and in makeshift huts across Leyte Island and nearby islands. These simple structures are proving no match for torrential rain and a rapid alternation of chilly breezes and sweltering heat.
Three Philippines Department of Health officials said in separate interviews on Friday night that acute respiratory infections, including pneumonia, were the biggest single public health problem to emerge since the typhoon.Three Philippines Department of Health officials said in separate interviews on Friday night that acute respiratory infections, including pneumonia, were the biggest single public health problem to emerge since the typhoon.
At a meeting on Friday evening, where representatives of several dozen domestic and foreign medical groups described the latest health concerns they had seen, “most were acute respiratory infections,” said Dr. Jim Bernadas, the acting chief typhoon health incident officer for Leyte Island, the island in the archipelago that suffered most of the casualties. Concerns about pneumonia came as the National Disaster Risk Reduction Management Council, a Philippines government agency, said the death toll had reached 5,209 by Friday evening. The agency uses a conservative figure for deaths that relies on bodies being found and logged by officials.
He attributed the respiratory infections to the widespread lack of shelter, saying further international relief was needed to provide tents. At a meeting on Friday evening, where representatives of several dozen domestic and foreign medical groups described the latest health concerns, most were acute respiratory infections, said Dr. Jim Bernadas, the acting chief typhoon health incident officer for Leyte Island, the island in the archipelago that suffered most of the casualties. He attributed the respiratory infections to the widespread lack of shelter, saying more tents were needed from international donors.
The department plans to compile on Saturday detailed information on the number of acute respiratory infections that have been diagnosed and officially reported to the authorities and properly logged, health department officials said. The department plans to compile on Saturday detailed information on the number of acute respiratory infections that have been diagnosed and officially reported to the authorities, Health Department officials said.
Dr. Rajiv Shah, the administrator of the United States Agency for International Development, said in a telephone interview from Washington on Friday that the United States government was concerned about reports of pneumonia in typhoon-affected areas. He estimated that 700,000 homes had been damaged by the typhoon, and said better shelter, nutrition and clean water were crucial to preventing a further spread of acute respiratory infections in the coming months.
Dr. Shah, a specialist in internal medicine, said the United States was donating plastic sheeting to provide better protection from the elements for vulnerable families and had donated food rations for 2.7 million people, including high-energy bars that may help strengthen the immune systems of children who have not been getting enough to eat since the storm.
Foreign medical teams are seeing so many cases that some of the smaller ones from nongovernmental organizations are running out of antibiotics and have to borrow more from other clinics, usually those set up by governments.Foreign medical teams are seeing so many cases that some of the smaller ones from nongovernmental organizations are running out of antibiotics and have to borrow more from other clinics, usually those set up by governments.
“It’s the constant rain while living under a tarpaulin,” said Dr. Ian Norton, the team leader of the National Critical Care and Trauma Response Center, an Australian government group based in Darwin that has deployed a full field hospital here complete with operating theaters.“It’s the constant rain while living under a tarpaulin,” said Dr. Ian Norton, the team leader of the National Critical Care and Trauma Response Center, an Australian government group based in Darwin that has deployed a full field hospital here complete with operating theaters.
Compounding the problem is that residents from all walks of life, from doctors and municipal officials to fishermen and manual laborers, lost every garment they owned when their homes were ripped apart by wind, water or both. Donations of used clothing from abroad have barely started to arrive — red and white plastic bags of clothing were being handed out Friday afternoon along Tacloban’s coastal road. Compounding the problem is that residents from all walks of life — from doctors to municipal officials, fishermen and manual laborers — lost every garment they owned when their homes were ripped apart by wind, water or both. Donations of used clothing from abroad have barely started to arrive — red and white plastic bags of clothing were being handed out Friday afternoon along Tacloban’s coastal road.
So most people wear the same T-shirt and shorts, often borrowed, for days on end. They cannot change when they get soaked in the rain, and the constant damp here makes it hard to dry anything.So most people wear the same T-shirt and shorts, often borrowed, for days on end. They cannot change when they get soaked in the rain, and the constant damp here makes it hard to dry anything.
Shelter has not been a big priority for aid groups, which have focused on bringing in food, water and medical supplies first. The result is that almost all the tarpaulins here are scavenged from debris, sometimes with holes or rips. Virtually no tents have been put up.Shelter has not been a big priority for aid groups, which have focused on bringing in food, water and medical supplies first. The result is that almost all the tarpaulins here are scavenged from debris, sometimes with holes or rips. Virtually no tents have been put up.
Pediatric respiratory cases that start as coughs and colds quickly worsen in this environment and can easily turn into pneumonia. “It’s a sign of the conditions of living — it’s raining every day,” said Dounia Dekhili, the Philippines emergency program director for Doctors Without Borders, as she stood under an open-sided shelter at the group’s clinic here and watched a cold drizzle fall.Pediatric respiratory cases that start as coughs and colds quickly worsen in this environment and can easily turn into pneumonia. “It’s a sign of the conditions of living — it’s raining every day,” said Dounia Dekhili, the Philippines emergency program director for Doctors Without Borders, as she stood under an open-sided shelter at the group’s clinic here and watched a cold drizzle fall.
Doctors Without Borders is bringing in tents, she said.Doctors Without Borders is bringing in tents, she said.
One of the many pneumonia patients here is Kesha Magason, a 3-year-old who lay shyly in her mother’s arms on a bed at Dr. Norton’s hospital on Friday afternoon after barely living through the previous night. Her mother, Jocelyn Magason, said that the tsunami-like storm surge had completely destroyed their home in Tolosa, a town 10 miles south of Tacloban. One of the many pneumonia patients here is Kesha Magason, a 3-year-old who lay shyly in her mother’s arms on a bed at Dr. Norton’s hospital on Friday afternoon after barely surviving the previous night. Her mother, Jocelyn Magason, said the storm surge had destroyed their home in Tolosa, a town 10 miles south of Tacloban.
The family survived the surging waters by climbing on the roof of their home, with Mrs. Magason and her husband passing up each of their four children, ages 1 to 11. They counted themselves lucky that the sea level rose less in Tolosa, becoming chest-deep in oceanfront low-income neighborhoods like theirs, than here in Tacloban, where it reached 13 to 20 feet.The family survived the surging waters by climbing on the roof of their home, with Mrs. Magason and her husband passing up each of their four children, ages 1 to 11. They counted themselves lucky that the sea level rose less in Tolosa, becoming chest-deep in oceanfront low-income neighborhoods like theirs, than here in Tacloban, where it reached 13 to 20 feet.
Kesha is asthmatic, and began having trouble breathing four days ago, her mother said. Kesha’s condition deteriorated over the next couple of day and her mother took her to a foreign medical mission — she was unsure of the name, but Australian nurses said that they thought it had been an international group called RescueNet. Kesha is asthmatic, and began having trouble breathing four days ago, her mother said. Kesha’s condition deteriorated over the next couple of day and her mother took her to a foreign medical mission.
The group recognized pneumonia and rushed the girl on Thursday to the Australian hospital, located next to Tacloban airport. The group recognized pneumonia and rushed the girl on Thursday to the Australian hospital, located next to the Tacloban airport.
“We thought she was going to die that night, and now she is sitting up, looking around with her mum,” said Dr. Norton, adding that specialized antibiotics had been used because of the complication of Kesha’s asthma. “We thought she was going to die that night, and now she is sitting up, looking around with her mum,” said Dr. Norton, adding that special antibiotics had been used because of the complication of Kesha’s asthma.
Dr. Frederic Ruckert, a surgeon for International Search and Rescue Germany, a nonprofit group, said in an interview at the group’s clinic in Palo, 8 miles south of Tacloban, that while respiratory infections were proving a problem, diarrhea had proved less of a problem than expected. The heavy rain may have washed away contaminants that might otherwise cause diarrhea, he said. Dr. Frederic Ruckert, a surgeon for International Search and Rescue Germany, a nonprofit group, said in an interview at the group’s clinic in Palo, eight miles south of Tacloban, that while respiratory infections were a problem, diarrhea had proved less of one than expected. The heavy rain may have washed away contaminants that might otherwise cause diarrhea, he said.
Amputations have also been less common here than after some natural disasters, although a few are still occurring. Dr. Norton said that numerous cases had been referred to the Australian hospital for possible amputation, but only two amputations had been necessary as the unusually extensive national disaster trauma center here, fully deployed by Australia for the first time to an overseas disaster, had been able to choose less drastic medical options and still save lives. Amputations have also been less common here than after some other natural disasters, although a few are still occurring. Dr. Norton said numerous cases had been referred to the Australian hospital for possible amputation, but only two amputations were necessary.

Austin Ramzy contributed reporting from Cebu, the Philippines.