Dr. Julieta Gabiola was back to the Philippines, her home country, twice last year, but in those two trips she might have been visiting two different worlds.
Last January, Gabiola, a clinical associate professor of medicine at Stanford University, traveled to the city of Tacloban as part of a weeklong medical mission. Ten months later, she returned to the Philippines with a team of medical volunteers from Stanford to again provide medical care, but under very different circumstances. She arrived two weeks after Typhoon Haiyan had swept across the country, knocking out electricity and communications, destroying homes and hospitals, and cutting off entire villages.
“It was chaotic,” Gabiola said. “Everything was decimated.”
“Seeing large steel and cement structures completely demolished was just astonishing to me,” said Brandon Bond, administrative director of the Office of Emergency Management for Stanford Hospital and Clinics. “But you saw resiliency in the people.”
According to the United Nations Office for the Coordination of Humanitarian Affairs, about 14 million people, or about 14.5% of the country's population, were affected by the storm. The most recent count of deaths, as reported by the government in late November, was more than 6,000, with another nearly 28,000 people injured.
Gabiola, Bond and eight other volunteers from the Stanford Emergency Medicine Program for Emergency Response (SEMPER) deployed to the Philippines on Nov. 22.
It isn't the first time Stanford has assembled a relief team following an international disaster
. In 2010, SEMPER sent four emergency physicians
and four nurses to Port-au-Prince, Haiti, five days after a devastating earthquake. “We sent different rotating groups every two weeks to a hospital there for about three months,” said Dr. Colin Bucks, associate director of SEMPER. “Afterward, we said, 'Hey, this is actually something we can do well. Let's start training folks and equipping them to go.' ”
Hauling an average of 160 pounds of equipment and pharmaceuticals per person, the most recent team of four doctors, three nurses, one nurse practitioner, a clinical social worker and an emergency medical technician arrived in Cebu City and then traveled to more remote and harder-hit areas to focus on primary-care services. Six went to an area 45 minutes south of Tacloban, while four went to the coastal town of Guiuan.
Bucks, a clinical assistant professor of surgery and an emergency physician, led the four-person team to Guiuan. “It was just wiped out,” Bucks said. “It probably took us four days to get in.”
Once they did, Bucks and his team, working with the help of Medical Teams International and logistical support from International Medical Corps, started seeing patients at regional health units. Some units were set up in the remnants of clinics, some in churches, and others outdoors in tents.
The volunteers handled some trauma cases—mostly involving people injured during storm recovery efforts. But most cases were primary-care related. People's respiratory illnesses had been worsened by the burning refuse and debris left by the storm, and their hypertension and diabetes went untreated because of an interruption in the basic health infrastructure.
“There are good local doctors and nurses, but they needed a chance to get their houses together and account for their families,” Bucks said. “We said, 'We're going to supplement you, and we'll set up tarps and tables and see your patients.'”
Sometimes that meant stringing up a tarp in an alleyway between buildings to shelter patients from the rain or hot sun. “In one case, we had an individual holding an umbrella over us while we cared for the patient,” Bond said.
Dr. Colin Bucks, Stanford volunteer
The teams worked from dawn to dusk—loading supplies and medicines in the morning, traveling to Filipino villages known as barangays to set up outreach clinics, providing care and returning to housing provided by International Medical Corps. The organization rented a family's house to use as a base camp. The son served as a translator and local guide for the group.
Each night, the teams unloaded supplies and entered data on the illnesses they saw. That surveillance data, reported to the Philippine Department of Health and World Health Organization, could then be used to monitor potential outbreaks of diseases such as dysentery and dengue fever. “The most important thing we could do is participate in surveillance and get hard numbers,” Bucks said. “Ideally, you want to prevent outbreaks with good hygiene, clean water and shelter. But giving them hard numbers (for tracking diseases) is honestly our biggest contribution.”
During their two-week trip, Bond said the 10 members of the SEMPER team treated nearly 6,000 patients. “We'd start to see patients within 30 minutes of setting up,” Gabiola said. “There'd be no roof, so we'd have to put up our tarp. Then every couple of hours, it would rain and we'd have to move so we didn't all get wet.”
Dr. Julieta Gabiola, Stanford volunteer, standing
The volunteers would get up at 6 a.m. and often work until 10 at night. Though Gabiola found the working conditions and long days exhausting, she didn't take much time to rest. The group returned to the U.S. on Dec. 8, but Gabiola is already back in the Philippines to lay plans for her next medical mission to the area in January 2015.
With the help of ABC's for Global Health, the not-for-profit group she founded in 2009, Gabiola plans to continue to respond to the long-term needs in the Philippines. For now, that means taking items such as eyeglasses, toothbrushes and vitamins to the people affected by the typhoon, and raising money to buy food and additional supplies. She wants to continue the work she started nearly five years ago with her not-for-profit group, preventing chronic illnesses through education and lifestyle modification.
“The local people are ready, the local talent is there,” Gabiola said. “They just don't have the resources.” Follow Rachel Landen on Twitter: @MHrlanden