GUIUAN, Philippines (Thomson Reuters Foundation) - One man waited on a bench for his turn with doctors, the skin on both his legs - at one time raw and bloody - scabbed over, while his stitched up left palm had become unnaturally swollen. Next to him was a boy with a big lump on the top of his left foot.
Many survivors of Super Typhoon Haiyan sustained relatively minor injuries when the storm whipped up a frenzy of falling cement and flying sheets of corrugated metal, but these knicks and gashes are increasingly becoming infected - and life threatening - as doctors scramble to operate, heal and save lives.
“Yesterday we had a very severe case,” said Dr Johan von Schreeb, a general trauma surgeon for the medical charity Médecins Sans Frontières (MSF) who has been in Guiuan for the past five days treating storm injuries.
“He stepped on something and had a very bad infection We sent him over to the private hospital but his relatives this morning said he passed away during the night,” he told Thomson Reuters Foundation on Tuesday from the makeshift outpatient unit MSF has set up at the damaged local health centre.
“It’s very important that these wounds are treated as soon as possible because if the infection is locked inside, it starts spreading and becomes septic and you can die from a very minor injury,” added von Schreeb, who had seen similar cases in Haiti after the earthquake in 2010.
Officials have tallied some 18,200 people injured by Haiyan (locally known as Yolanda) - most of whom suffered punctures and lacerations.
MSF, which warned the risk of skin disease, diarrhoea and tetanus are high in storm-hit areas, has set up and offered inpatient and outpatient services in Guiuan since Friday. It had conducted 60 minor surgeries for lacerations, broken bones and infected injuries, and provided more than 1,000 consultations in three days.
When Haiyan tore through central Philippines on Nov. 8, it cut a wide path of destruction, washing away communities, killing thousands and displacing more than 4 million people. The health infrastructure took a major hit, with the latest U.N. report saying 47 of the 115 healthcare facilities assessed are not functioning.
MSF’s von Schreeb, however, called local doctors like Ma Socorro A. Flores - the head of the clinic in Guiuan where von Schreeb is working - “true heroes” for keeping things ticking despite the overwhelming scale of the disaster.
Although the storm blew away the roof of Flores’ house, leaving her family to take refuge in the kitchen, the morning after the storm, she headed to the clinic in her pajamas and found a queue of people with injuries.
She immediately went to work, rummaging through the debris to find the extra supplies she had stockpiled before the storm.
“Our goods were not enough for the magnitude of people affected, and we had no needles or anesthesia, so we just packed the wounds and gave antibiotics,” she said. Serious cases were transferred to the capital Manila or nearby island of Cebu, or referred to a private hospital in Guiuan that was still up and running.
Now that MSF has set up the outpatient clinic, Flores is hoping to focus on providing primary care.
“I’m worried about the health impacts from the storm. There's a lack of water, shelter and toilet facilities because they were almost all destroyed so people are now defecating everywhere,” she said. “There are also a lot of mosquitoes and we're afraid of dengue.”
On Tuesday, the sun bore down on Guiuan. The ferocious winds had snapped most trees into half or felled them completely, while most homes and public buildings no longer have roofs - leaving little shade and shelter.
Life is slowly returning to normal, with three-wheeled rickshaws running again and the seafood for which the town is famous being sold again in makeshift shops.
Yet dozens of people were still lining up at the damaged airport hoping for a flight out, reflecting the difficult living conditions for many.
“It’s very important that health services are back up and running as soon as possible because if health is a problem everything else goes down. If you’re sick, you can’t work and you have no income,” said Flores.
The throng of patients at her clinic on Tuesday morning gave a sign of the health needs to come.
Orland Queasada, 32, was with his 2-year-old son Christian, whose asthma had worsened after the storm. Living in a tent after their home was badly damaged, Christian became feverish after getting wet from Monday night’s rain. The doctor’s diagnosis was respiratory illness.
“Our youngest child is also ill. She started having a fever and diarrhoea yesterday because we ran out of the clean water I bought before the storm,” said Queasada, a government worker. “After Christian, we will come back with her.”
At the inpatient tent, surrounded by the rubble of the former general hospital, is Lorna Marciano, a 25-year-old housewife, who came to the MSF clinic on Monday with her 5-month-old son after fellow villagers told her about free medical care. They travelled one and a half hours on a rented motorbike as the baby’s fever raged.
He was diagnosed with dengue with pneumonia complications - a result of being soaked for three hours when Haiyan struck.
Uncomfortable and restless, the baby had frequent crying fits, while Lorna is suffering a cough herself.
"He's our only child," she said, as she cradled and tried to comfort him.