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Tacloban, Philippines (AFP) Nov 21, 2013
Inflatable field hospitals have been erected in the typhoon-ravaged Philippines city of Tacloban, part of a huge international relief effort to help millions hit by the storm.
Medecins Sans Frontieres (Doctors Without Borders) have five of the large white tents that they have brought with them from France.
By Thursday afternoon three of them had been erected.
They will give the organisation the capacity to do both in-patient and out-patient consultations, emergency treatment and surgery in a sterile environment, said MSF logistician Damien Moloney.
"It's a pretty big operation," Moloney told AFP in Tacloban on Leyte island. "We're here to give support to the local health structure. We want to help them get back on their feet."
MSF has been working in various parts of the typhoon disaster zone for around a week.
The group's emergency coordinator Natasha Reyes said some of the most serious cases were in Guiuan on Samar island where the storm made landfall, where 600 people came for treatment on their first day of operation.
Among them were some who were injured as a direct result of the 315 kilometre (195 mile) per hour winds.
"We've seen.... people needing minor surgery -- procedures needing local anaesthesia for suturing, cleaning of infected wounds and the routine setting of broken bones," she said.
"The team saw some very nasty head wounds. Some had previously been stitched up but had since become infected, and the clinic had to start again and clean the wound."
In other parts of the disaster zone, medics have been dealing with puncture wounds from people stepping on nails as they scramble over the debris, who needed treatment for tetanus.
Reyes said some patients came to them as indirect victims of the storm, including an older man with a serious lung condition.
"He wasn't doing well," she said. "He had lost his inhaler, which is distressing and dangerous in his condition. For people with chronic diseases like that, it's particularly hard."
A lack of clean drinking water has given rise to gastrointestinal infections and diarrhoea, especially among children.
"All of our medical teams are on the lookout for the very dangerous diseases that are endemic in the area -- typhoid, schistosomiasis, cholera and leptospirosis," said Reyes.
"The worry is that the conditions people are living in as a result of the disaster might trigger an outbreak."
Typhoon Haiyan, which smashed through the central Philippines on November 8, was one of the most powerful storms ever recorded on land.
Its winds whipped up a storm surge that flooded a large stretch of coastline, destroying buildings and infrastructure.
Around 5,500 people are dead or missing after the storm, which affected more than 13 million people, of whom 4.4 million are now homeless.
Nurses battle fatigue in tide of Philippine typhoon births
The nurses, who are working in 24-hour shifts, wrap him in plastic to keep him warm because they do not have an incubator.
His exhausted and emotional mother, 21-year-old Emily, lies on a bare mattress on the floor of the next room, watched over by her cousin.
"I am happy," she says, wiping away tears. "But it's difficult."
Nurse Jerbies Lames says Kyrie needs antibiotics to help him fight off a possible infection picked up during his complicated 4:00 am birth.
He can breathe for himself, but needs oxygen from a tall green cylinder that stands nearby, one of only a few dozen the neo-natal ward has access to.
"We borrow them from other wards, but they need them also," says Lames, who was rotated into the unit just days before Typhoon Haiyan struck, whipping up waves that swamped the city of 220,000 people.
The Eastern Visayas Regional Medical Center is the only hospital still taking patients in Tacloban.
Its buildings are intact, but the influx of people needing help is stretching its already-thin resources.
Breastfeeding mothers lie on mattresses squashed together on the floor, or sit fanning their babies with pieces of cardboard as they sleep fitfully in the heat.
Every bit of available space is pressed into use, with women and their children perched on bed frames that line the corridor.
Lames, whose calm professionalism belies his 24 years, is one of just four nurses looking after 36 newborns on the day AFP visits.
When their all-day shift is over, they will have 24 hours' rest before coming back on duty. It is a pattern they have repeated since the huge storm of November 8.
Three cots along from Kyrie, a young mother changes the nappy of a fragile-looking little girl.
The scrap of paper above her head gives her family name as Uotuhan. She too was born at just 32 weeks and faces a fight for survival.
Her anxious mother wraps a single blanket around her and strokes her tiny cheek.
Babies died from treatable conditions
Things have improved at the hospital since the early days after the typhoon.
In the immediate aftermath some babies died from conditions that are normally treatable, such as hypothermia and hypoglycaemia, Lames says, often because nurses were unable to examine them properly at night because there was no power for lights.
Aid groups have delivered supplies, including generators, and a team of medics from Spain is working in the hospital.
"We are thankful because now we have some stocks of medicine.
"But we are the only hospital accepting patients, so it makes it difficult to anticipate how long it will last," Lames says.
Along the corridor, the children's general intensive care unit is crowded with babies and infants.
Two-month old Princess Balisal was admitted with vomiting. She is settled enough now for her mother to feed her a yellow solution from a small syringe.
Nearby, Cynthia Pontejos fans her two-year-old son, Kim, with a flattened cookie box. They were brought in by an ambulance overnight because he was having an asthma attack.
"The nebulisers that we depend on were washed away by the flood," she says.
Kim and his older brother were both born in a private hospital. Now the family lives in a garage, their home washed away by the surging seawater.
Cynthia, 28, is sanguine about her family's fate.
"We have no home, no clothes, no money, and I have no idea how to start again. But I still feel grateful," she says. "We are all still alive."
Back on the neo-natal ward, Lames confers with a Spanish volunteer nurse, helping to coordinate the teams.
"We are encouraging the patients to breastfeed," he tells her. "Some of the first-time mothers needed a bit of help with proper positioning and attachment."
When he has finished talking to her, he checks his little charges again, making sure Kyrie's oxygen level is set correctly.
As he squeezes past a huddle of mothers clutching their babies, he smiles kindly at one and touches her arm.
Then he's off to fill in the notes he must keep updated until he hands over to the next 24-hour shift at 7:00 am.
Lames is philosophical about his long hours, the shortages and the cramped ward.
"It's not ideal," he shrugs. "But it's the only way we can help."
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