(Corrects in paragraph 2 date that typhoon hit Philippines to Nov. 8.)
CEBU, Philippines (Thomson Reuters Foundation) - The risk of skin disease, diarrhoea and tetanus are high in storm-hit central Philippines where homes have been flattened and most of the health infrastructure damaged, medical charity Medecins Sans Frontieres (MSF) said on Sunday.
Typhoon Haiyan, possibly the strongest storm ever to make landfall, struck the Philippines on Nov. 8 killing more than 3,600 people and displacing 4 million more. Despite preemptive evacuations and warnings, the ferocity of the storm overwhelmed the government and aid agencies.
Many of the displaced are living outside evacuation centres amid the debris and what's left of their former homes. Access to food, clean water and sanitation is limited in storm-hit areas where electricity and communications are also patchy.
"One of the emergencies in the short-term is to restore a minimum of access to healthcare for the population," said Jean Pletinckx, MSF emergency coordinator who is overseeing the organisation's response to Haiyan, known locally as Yolanda.
"In all the main and remote areas we went, there is no more health infrastructure. All of them are damaged or partly damaged," he told Thomson Reuters Foundation.
Returning from a visit to Guian, he said the town - on the far east of Samar Island where the typhoon made its first of six landfalls - was completely destroyed.
"There's nothing left. Everything is broken. The hospital is completely flattened. The health post also and all the facilities," Pletinckx said.
MSF started providing healthcare in Guiuan on Friday, working amid the ruins of the local hospital. It has so far seen hundreds of patients and carried out about 35 minor surgeries.
"The first concern for MSF is the wounded people. We had to reopen a couple of the wounds and fix them properly. The risk of infection is quite high," Pletinckx said at Cebu, the hub for most humanitarian operations.
MSF warned that unhygienic and overcrowded makeshift living conditions can increase the risk of skin diseases, respiratory diseases, diarrhoea and a bacterial disease called leptospirosis, contracted from walking in or ingesting flood water carrying infected animal waste.
The medical aid agency has already seen an increase in diarrhoea in some storm-hit areas, possibly due to people drinking contaminated water.
"It's raining a lot there so everything is wet. The risk of infectious disease and respiratory disease are very high," Pletinckx said, adding that access to clean water was urgently-needed to avoid more water-borne diseases.
The risk of tetanus is also a worry. Debris, including twisted corrugated iron sheets and broken glass, has only been partially cleared in many places.
The sheer amount of debris as well as a lack of manpower, transport and fuel have hampered relief efforts.
Pletinckx said the logistics of reaching people in need in the Philippines was more complicated in his experience than in Indonesia after the 2004 Indian Ocean tsunami and Haiti after the earthquake in 2010.
Many survivors are living on islands where all the facilities have been destroyed.
MSF said in two or three days, it would be fully operational in Tacloban, one of the worst affected areas in Leyte province, and will distribute relief to people in remote areas.
The aid group is setting up an inflatable hospital in Tacloban and organising healthcare in other towns in Leyte. It is also setting up two outpatient departments on Monday in Panay Island.
"If we should have more fuel, we'd be able to move quickly inland," Pletinckx said. "I was in Guiuan yesterday and we tried to find 50 litres of fuel. It was a nightmare just to find 50 litres."
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