Weak primary health care

Rebuilding shattered health system an urgent priority in next phase of

Typhoon Haiyan (Yolanda) response

Primary health care is usually the first point of contact people have with their health care
system, and ideally should provide comprehensive, affordable, community-based care
throughout life. 

Primary health care can meet the majority of a person’s health needs of the course of their life.
Health systems with strong primary health care are needed to achieve universal health
coverage. 

WHO/F. Guerrero

One month after Typhoon Haiyan (Yolanda) hit the Philippines, the World Health
Organization (WHO) identifies as top priorities expanding essential health services,
reviving clinics and hospitals, preventing disease and scaling up mental health services
as the relief effort shifts from emergency to early recovery programmes.

The typhoon, one of the strongest ever recorded, tore through the central Philippines on
8 November, sweeping away villages, killing more than 5700 people, wreaking havoc on
the lives of more than 11 million others and damaging the majority of medical facilities.
From the outset of the disaster, WHO has been working side by side with the
Philippines Department of Health to assess and address the life-saving needs of
survivors and coordinate the emergency health response.

“Our immediate goal was to help plug critical gaps in medical services and to get the
right experts and supplies into the right places swiftly and efficiently,” says Dr Julie Hall,
WHO Representative in the Philippines.

One month into the crisis, 181 medical teams (65 foreign, 116 local) are delivering
critical care in affected areas. WHO has coordinated the distribution of more than 72
tonnes of medicines and supplies to support the relief effort. A mass campaign to
vaccinate children under five against measles and polio is underway in storm-hit
communities and evacuation centres. WHO and partners have also worked with the
Government to reactivate disease monitoring and reporting to ensure cases of
infectious diseases are quickly identified and responded to.

The risk of infectious diseases remains high, particularly in the crowded and unsanitary
environments where hundreds of thousands of homeless people are now sheltering.
Infectious diseases like measles, water-borne diseases such as typhoid fever and
vector-borne diseases like dengue, can thrive in such conditions.

However, the primary reasons people in affected areas are seeking medical care right
now are acute respiratory infections, fever, diarrhoea, high blood pressure, skin
diseases, new injuries from clearing debris and follow-up care for injuries and wounds
sustained in the typhoon.

The medical teams are also tending to on-going health needs, including maternal and
child health care. An average of 865 women give birth every day in affected areas,
among whom an estimated 15% will experience complications, some of them life-
threatening.

With many foreign medical teams preparing to leave within the next month or two and
others arriving, WHO is working with the Department of Health to ensure a smooth
transition. Dr Hall says it is critically important that gaps in services do not emerge and
that international attention and support to the health sector does not wane.
“We must ensure that essential health services are not interrupted and that in the
months to come, the Philippine Government as well as humanitarian aid organizations
and other key partners have adequate resources to restore health services across the
affected region,” says Dr Hall.

At the one month mark crisis, priorities for the health sector include:

 Extending and expanding treatment: Providing free primary and emergency

health care as Philippine medical services are re-established. Special attention is
required for obstetric and neonatal care and treatment of chronic diseases and
infections like tuberculosis.
 Preventing disease: Strengthening disease surveillance and response systems
to inform health care needs and prevent the spread of disease. Other essential
preventive measures include increasing coverage with recommended vaccines,
pre-positioning supplies for possible outbreaks and improving waste
management and water supply.
 Restoring health infrastructure and systems: Supporting the Philippine
Government as it repairs and rebuilds medical facilities and restores the drug
supply and routine health programmes. Health authorities are still tallying total
costs, but say they need an initial P 1.4 billion (around USD 32 million) for basic
repairs and replacement of equipment and medicines.
 Integrating healthcare with other key services: Linking health care with social
support programmes, especially mental health assistance. WHO and the
Department of Health have trained Filipino health professionals who will in turn
train field workers to deliver psychological first aid to typhoon survivors.

“Rebuilding the health system is going to be part and parcel of rebuilding lives and
livelihoods in central Philippines,” says Dr Hall. “Given the scale of this disaster, it’s
going to take a healthy population to fuel the region’s recovery.”