Background: Typhoon Haiyan, equivalent to a category 5 hurricane, has affected an estimated 9.9 million people in the Philippines. The storm, which made landfall on November 8, caused widespread devastation, displacing 3.4 million people and destroying over 1 million houses, according to the United Nations. This rare and very powerful storm has severely disrupted the delivery of critical health services, and access to safe water continues to be a serious problem for the affected regions.
Since access to affected areas has improved with the clearing of roads and the re-opening of most airports, relief efforts from humanitarian organizations and the Government of the Philippines have scaled up substantially. While humanitarian assistance is getting through to the hard hit areas urban areas with high populations, efforts must continue to extend to the rural and remote villages, many of which have not received any assistance to-date.
Urgent Need for Intervention: Despite large-scale efforts to rehabilitate water systems in the affected areas, many rural and remote regions still lack clean sources of water today. People may have to walk up to 10 miles to access clean water, or rely on unsafe water sources including surface water or open wells. Getting water to people –and storing it – is also a challenge. Although the roads have opened up, bringing water via trucks to large areas is limited due to a shortage of trucks and fuel. Additionally, limited water storage capacity is making it difficult for families to meet their daily water needs. Making matters worse, the devastation of basic household infrastructure – toilets and latrines – and the disruption of trash and waste removal in affected communities has put their populations at-risk for outbreaks of preventable water-borne diseases.
International Medical Corps Emergency Response: International Medical Corps is on the ground in the Philippines providing medical services through ten mobile medical units in some of the hardest-hit areas following Typhoon Haiyan. International Medical Corps is also conducting water, sanitation and hygiene; medical; and mental health assessments in affected communities, and has begun nutrition screening and treatment referral for children.
By working through mobile medical units, International Medical Corps has been able to provide critical health services on remote islands where families struggle to access medical care and basic resources
International Medical Corps, along with local health authorities, has begun to focus on the public health threat of epidemics in communities where access to safe water is unsteady or not possible. In conjunction with the delivery of medical services in affected areas, International Medical Corps is identifying unmet water, sanitation, and hygiene needs in these areas. International Medical Corps is focusing on providing water, sanitation, and hygiene support to temporary health structures; distributing hygiene and water kits; and improving the availability of water through repairs to distribution systems and treatment of water sources.
A Proven Solution: As part of its partnership with DayOne Response to deliver clean water during emergencies, International Medical Corps is working to transport and distribute approximately 200 of DayOne Response’s Waterbags and P&G Purifier of Water to families affected by Typhoon Haiyan. The Waterbag when combined with P&G’s Purifier of Water can provide clean, drinkable water for individuals and communities directly affected by the disaster. International Medical Corps is transporting them to its bases of operation in the Philippines for further distribution through its mobile or stationary health services in areas with limited access to clean water, as needed. The Waterbags were piloted previously during International Medical Corps’ response to the Haiti Earthquake in 2011, and proved to be a potent solution to water shortages that arise during the recovery period after a widespread disaster. Tricia Compas-Markman, DayOne Response’s CEO, had this to say about deploying the life-saving Waterbags to the Philippines:
“The collaboration between DayOne Response, Procter and Gamble’s Children’s Safe Drinking Water Program, and International Medical Corps, enables our teams to reach families affected by the typhoon with innovative solutions for clean drinking water. This is taking form by providing them direct access to clean drinking water through the DayOne Waterbag™ and P&G Purifier of Water™. The robust water purification system supports International Medical Corps comprehensive WASH approach in both households and health clinics, empowering communities to directly to treat their own water. This is an exciting effort to be involved with!”
International Medical Corps was one of the first organizations to arrive in Benghazi, Libya following the February 2011 outbreak of violence, and has since expanded throughout the country to Misurata, Sirte, Tripoli, Sabha and the Western Mountains region. During the conflict, International Medical Corps’ emergency response teams provided critical supplies and medical personnel to support health facilities; conducted medical consultations and lifesaving surgeries; provided emergency care for patients requiring medical evacuation; delivered essential supplies for people displaced by conflict; and trained local health care professionals.
Today, though the conflict has largely ended, International Medical Corps is still active throughout Libya and working in collaboration with key local stakeholders to help rebuild the health infrastructure through a variety of critical programs. Funds received through Global Giving were used along with government grants and other private donations to deliver these life-saving services to the people of Libya.
International Medical Corps’ Initial Emergency Response:
Nursing Support: During the conflict, in response to critical shortages of skilled nurses, International Medical Corps provided nursing staff to address acute gaps at hospitals in Sirte, Misurata, Zintan, Jadu, Gharyan, Tripoli and Sabha. True to our mission to return devastated communities to self-reliance, International Medical Corps’ specialized personnel simultaneously conducted on-the-job trainings to strengthen the capacity of Libyan nurses. Because the shortages for skilled nursing staff extend to the primary health care level, trainings were also being undertaken at International Medical Corps-supported clinics in the Western Mountains and Sirte.
Rehabilitation: International Medical Corps’ rehabilitation program focused on those affected by the conflict, and provided physiotherapy and psychosocial support services through facilities in Benghazi, Misurata, and Sirte. To strengthen local capacity, trainings of local staff were also being conducted by physiotherapists trained in rehabilitative physiotherapy best practices and by rehabilitation staff trained in providing psychological first aid.
Gender-Based Violence Prevention and Response: International Medical Corps trained social workers, psychologists and Libyan non-government organizations (NGOs) in guiding principles of gender-based violence (GBV) response; in addition, International Medical Corps also trained medical professionals on the clinical management of sexual assault survivors. Awareness campaigns to aid the prevention of GBV continue in four cities, and community awareness sessions took place within cities of operations, as well as internally displaced person (IDP) camps and towns outside of these cities. International Medical Corps continues to support women’s centers and clinics in Zintan and Misrata, to provide a safe space for women recovering from GBV.
Primary Health Care Support: Throughout the conflict, mobile medical teams supported primary health care clinics across Libya. In areas around Tripoli, Misrata, and Sirte, International Medical Corps provided medical care for internally displaced persons (IDPs) at clinics located in settlement areas. International Medical Corps also provided support in the Western Mountains, with mobile teams supporting community clinics and complementing these services with health education sessions for patients diagnosed with, or at risk of developing chronic diseases. Teams also distributed urgently needed items to clinics. International Medical Corps primary health care support also reached beyond the Libya, and on the Libyan/Tunisian border, International Medical Corps operated a health post at the Shousha camp to provide services to third country nationals and refugees who fled Libya during the conflict.
Current International Medical Corps Programming in Libya:
Nursing Support: The departure of foreign nurses during the conflict left a large service gap for nursing care at a time when service capacity had been outstripped. Today, International Medical Corps is engaging the Ministry of Health, the Ministry of Higher Education, universities and training institutes in Libya to address longer-term development challenges that includes strengthening the nursing sector. As part of this strategy, International Medical Corps provides theoretical and on-the-job training to Libyan nurses and is working on developing a longer-term nurse sector strengthening strategy, that includes developing pre-service and in-service nursing curricula, forming nursing counsels, and encouraging the promotion of Libyan nurses into key leadership positions. To date, over 400 nurses have been provided with clinical lectures and on-the-job training, with over 30,000 patients receiving treatment from International Medical Corps-trained personnel.
In addition, International Medical Corps is working with Johns Hopkins University to develop guidelines for nursing core competencies. These guidelines will be shared with relevant stakeholders to implement in nursing schools and training institutes throughout the country.
Rehabilitation Services: The conflict in Libya resulted in large numbers of casualties often with severe, life-altering wounds including amputations and head wounds, in addition to psychological trauma. Post-conflict, International Medical Corps is building on its emergency rehabilitation work to develop holistic rehabilitation services for those with physical disabilities. The program is focused on ensuring access to appropriate physical rehabilitation services while also promoting access for persons with disabilities to other measures that promote their full participation and inclusion in society.
To date, over 5,000 client rehabilitation consultations have taken place with doctors, physiotherapists, and prosthetics and orthopedic technicians. The program, which operates in Tripoli, Benghazi, Sirte, and Misrata, has also conducted upgraded trainings for 142 center staff members, including physiotherapists, occupational therapists, social workers, and prosthetic/orthotic technicians. International Medical Corps also engages local disabled person’s organizations to strengthen pre-service training efforts. The program also has a staff mentoring module in place to provide on-the-job support.
Prevention/Response to Gender-Based Violence: International Medical Corps is working to strengthen the ability of local health staff to identify, manage and treat GBV survivors through capacity building trainings; improved awareness of GBV; and improved reporting of GBV cases. In order to achieve these goals, International Medical Corps is working with all sectors of the Libyan population, from government ministries to schools, and through medical staff working with local community based organizations (CBOs).
To date, International Medical Corps has trained 1,134 key stakeholders, including teachers, ministry staff, hospital and clinic staff, and social workers on the prevention of sexual exploitation and abuse and the principles of GBV. International Medical Corps is also working with local CBOs to establish safe spaces and recreational centers for women. These centers will provide life skills classes and information sessions for women who go to these safe spaces. To date, one safe space has opened and another two have been identified for support. In addition, International Medical Corps is providing awareness session to community leaders and community focal points on the program, as well as GBV in general, to ensure public buy-in of these values and principles.
Primary Health Care Support: Support to the primary health care sector has been a key feature of International Medical Corps’ work in Libya. International Medical Corps has used mobile medical teams to address staffing and supply gaps as well as training needs in facilities in rural areas and in communities with high levels of displacement. Today, International Medical Corps works with persons of concern detained in holding facilities, located in Gharyan, Al Khoms, Tripoli, Sorman, Sabratha, Sabha, where undocumented migrants, asylum seekers and refugees have been brought. This population is extremely vulnerable and lacks access to much needed basic health care. To illustrate this point, in just a four month period, International Medical Corps provided over 6,000 health consultations. International Medical Corps has been supporting these detention centers and these populations for over 13 months and will begin providing support to a community development center that provide basic services for urban refugees in Libya.
In the months following the conflict’s end, International Medical Corps has transitioned programming from emergency response to development programming. Nearly all of International Medical Corps’ programs today focus on helping ensure that the health sector in Libya is rebuilt in a strategic, thoughtful manner. International Medical Corps is continually engaged with ministry officials, local CBOs, and the community to ensure that program goals and design continue to have buy-in from these key stakeholders, moving Libya from relief to self-reliance.
The program we originally set out to deliver with Global Giving support has been completed and our project is fully funded! We are still supporting the health and well-being of the Libyan people, however, we have shifted our main focus to training nurses in the country in order to help meet the demand for well-trained medical professionals that are in very short supply in Libya. The continuation of our mission will be supported by the Ministry of Health, the Ministry of Higher Education, universities, training institutes and other private funding sources. International Medical Corps is very grateful for all of your support in our mission to provide relief to the Libyan people.
Yesterday (November 14th), an International Medical Corps team, including medical staff and water, sanitation and hygiene experts landed in Guiuan, on a remote island of the Philippines. They were met by hundreds of people on the tarmac, and immediately begin providing medical relief.
Typhoon Haiyan made landfall at Guiuan, knocking out water, power and communication. Two of the island’s three hospitals have been completely destroyed. Our teams have provided medical care for infected wounds from flying debris; upper respiratory infections; and complications from a lack of available medication for chronic diseases, such as diabetes. There have already been cases of diarrheal disease caused by a lack of clean drinking water, and local health officials fear an increase in cases of tetanus, dengue fever and measles in the coming weeks and months.
Just two hours after the team landed, we spoke to Margaret Aguirre, a member of our Emergency Response Team, and she noted "We were able to see the scope of the devastation. It was immense … Whole villages were flattened … We brought in food, water and medicine with us, and we’ve already begun treating patients … There are whole villages in Guiuan that have not been reached yet. That’s where we are going to be going.”
To meet the needs of the people of Guiuan, International Medical Corps is operating mobile medical units and providing access to clean water and hygiene promotion to thwart the spread of disease.