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Philippines Programme Reports


2 Mar - AAI Philippines Health Recovery Program, Weekly Update 09: 2 March 2014

Click here to download the report

23 Feb - AAI Philippines Health Recovery Program, Weekly Update 07: 23 February 2014

Click here to download the report

20 Feb - AAI medics help save baby Joy.

Baby Joy presented to the Concepcion health centre with difficulties breathing. She was slipping in and out of consciousness.
Her mother was desperately worried – just four hours ago Joy had been suffering from nothing worse than a mild cough and fever.
AAI’s medical personnel station and the health unit in Concepcion spotted Baby Joy in distress in the waiting room and immediately took her in for care.
Dr Farnaz Sabet, AAI’s lead physician, diagnosed her with acute pneumonia and worked with Lisa Vermeulen, an AAI emergency nurse, to stabilize her and get her to the closest hospital.
Baby Joy was kept as an inpatient at the hospital in Iloilo City for almost a week as she recovered. She was discharged happy and healthy to return to her family in Nipa, Concepcion municipality.
Baby Joy’s family lost their home when Typhoon Haiyan hit the Philippines. Her father, a fisherman, also lost his boat which was the family’s only source of income.
Even months after the typhoon, many families in the Philippines are still living in evacuation centers or sharing houses with family.
“After the typhoon, with poor housing conditions and overcrowding, you will see many more respiratory illnesses amongst children,” Dr Sabet said.
Access Aid International, in partnership with Direct Relief, provides primary healthcare support to local health authorities in the Philippines to make sure that children like Baby Joy have access to life-saving medical care.


Baby Joy in an ambulance with AAI Emergency Nurse Lisa Vermeulen

Community level health monitoring is of especially important in areas like Concepcion, Philippines. With numerous isolated island communities, diagnosing childhood illnesses early and referring sick children for treatment is of crucial importance.
Access Aid International, in partnership with Direct Relief, has been conducting training sessions for community health workers from Concepcion’s island communities.
The training teaches health workers how to treat common childhood illnesses and monitor their communities for sick children presenting with ‘danger signs’. The training includes a referral system where children presenting with danger signs can be referred by community health workers to the main health clinic in Concepcion for further treatment.


Bec, a community health worker, gets on-the-job training treating sick children at a training session in Concepcion, Philippines.

16 Feb - Dr Larry Stock - International Emergency Medicine and DART.

Click here to road an article written by Dr Larry Stock on International Emergency Medicine and DART in the Emergency Medicine Residency & Department Newsletter Winter 2014 for UCAL Olive View.

 

14 Jan - AAI Philippines Health Recovery Program, Weekly Update 01: 13 January 2014

AAI Health Recovery Team returns to the Municipality of Concepcion, in Iloilo Province, on 9 January
after short break to commence our Health Recovery Program, funded in partnership with Direct Relief.
Since arriving in the country, program personnel have made contact with key partners in the Iloilo
Provincial Administration, Provincial Health, and Concepcion Municipal Health Office (MHO).

Click here to download the report

13 Jan

On November 13, five days after the most powerful tropical cyclone ever recorded struck the Philippines, AAI’s Disaster Assessment and Response Team (DART) began providing emergency healthcare and vital assistance to remote island communities which were directly impacted by Typhoon Haiyan. After almost nine weeks, the initial response phase of our program has been successfully completed and we have now partnered with Direct Relief International to continue our operational presence in the Philippines. Through this partnership, we are working to rebuild local birthing centres, train local health workers in the management and treatment of childhood illnesses and continue providing support where needed to local health authorities. We would sincerely like to thank all of our personnel, volunteers as well as our local and international partners for their hard work and support.


4 Dec

AAI has been supplementing Concepcion's local health clinics with medical assistance for a couple of weeks now.

We have noticed that local activity has been increasing over the last few days and many residents from the surrounding islands have travelled to Concepcion or supplies, which are increasingly available in the markets now. This is also an opportunity for the islanders to access further medicines, treatment and medical investigations not otherwise available on the remote islands.

AAI has been able to conduct follow up consultations with patients who have previously been seen by our medical teams on the islands where AAI have beennning outreach medical clinics.

The health clinic at Concepcion city is staffed by two medical officers and a complement of nurses and midwives. These same doctors and nurses have been accompanying AAI on our deployments to the remote islands where AAI provides primary care to communities affected by Super Typhoon Yolanda.

Today a case of anaphylaxis (severe life threatening allergy) was encountered at the medical clinic. A 15 year old girl with a known previous allergy to eggs presented to the clinic with her mother after eating sardines potentially combined with egg. She presented with the typical urticarial rash and then developed difficulty breathing. The AAI team were called to assist at which point she was quite unwell. She required intramuscular adrenaline, intravenous fluids and oxygen. AAI staff stabilised the patient and managed her care as she was rushed to the nearest hospital. She has recovered and is now well.

AAI staff has assisted with thee management of several wounds and excised some foreign bodies and skin lesions from several patients. These procedures would typically be referred to the local hospital which require transport and significant cost the patient for the surgery.

Tomorrow AAI will once again undertake an outreach clinic to the islands surrounding Concepcion in support of the provincial medical staff.

 
Damage to one of the health facilities in Concepcion
where AAI is providing assistance
Dr Shaun and nurse Emma remove a foreign
object from a patient in Concepcion

 Nov 29

AAI DART team deliver medical aid to the easternmost Island Barangay of Malangabang.

AAI's medical response continues in the Philippines with the team running medical outreach clinics daily in the  island communities of Concepcion. Today the team is in Malangabang working with Municipal Health Officer DR. Helen Minguez to provide medical care to over 100 patients.

The people of Malangabang are starting to rebuild, however, they lack shelter, boats for fishing and food. This serves to compound the health issues of vulnerable demographics such as children and the elderly.

The AAI team will continue to provide medical aid to the islands and targeting those most vulnerable in the communities.

 
Dr Shaun Francis treats patients in Malangabang Barangay
 
 
Emergency nurse Emma Childs treats wounds
to a child's foot on Igbon Island.
Dr. Shaun Francis and Emma Childs see
patients on remote Concepcion island.

27 Nov

AAI's Disaster Assessment and Response Team continues to provide much needed medical aid to the typhoon disaster affected population of the Concepcion islands.

AAI's DART team has now run medical clinics on all the main islands of the municipality of Concepcion. AAI is working closely with the Municipal and Provincial government as well as with long time partner Direct Relief to ensure those most in need have access to medical aid.

AAI Emergency nurse Emma Childs reports from the field that "we are still seeing a number of typhoon injuries such as foot wounds and second order effects such as injuries from debris and illness related to the lack of food, shelter and, in some cases,  water"

In Island Barangay Igbon, local community leader Lizandra Plotenia told the AAI team how "the people fled to the cemetery to seek shelter from the storm surge and debris flying around like bullets"

AAI will continue to work with the local island communities to ensure they have access to medical aid in this time of need.

 
Ops Manager Gordon Willcock assessing
Barangay Bagongon Health Clinic.
AAI DART use local fishing boats to reach
remote islands in order to delivery medical aid.

 

 
Dr. Larry Stock sees patients on Danoa-Danoa island
 

 

19 Nov

AAI responded to devastated communities in the Barangay Macatunao on the Island of Pandi Asukal off the coast of Conception.

AAI focusing on the needs of the remotest hardest to reach communities. The AAI DART team assessed that the village was 90 per cent destroyed by the Typhoon.

Local residence said that the when the typhoon came the villagers escaped into the mountains Islands. They said the storm surge sent waves which reached the lower branches of the palm trees.

AAI first international NGO to go to respond to the Island. Over 100 patients seen in 2.5 hours

Doctor Larry and Brad treated some serious respiratory problems, multiple patients with pneumonia and bronchial spasm, dehydration and sepsis.

AAI DART team doctors and nurses focused on specific patient needs and the judicious use of medication.

AAI team returning to the Islands tomorrow to give much needed medical assistance to the devastated communities of Panay's easter Islands. 
 
 
Aai nurse Sophie Wallace assists sick girl in
Barangay Maliog Liog
AAI nurse Emma Childs treats typhoon
injuries in Barangay Dungon
 
Devestation wrought by Typhoon Yalonda on
Barangay Dungon
 

 

18 Nov - AAI's Disaster Assessment and Response Team (DART) is working with local doctors and health services to deliver medical aid to the isolated islands of east Panay.  

AAI DART team is working with Iloilo Provincial Department of Health to provide much needed medical aid to the isolated Typhoon disaster affected Islands of the municipality of Concepcion. The AAI team report that the force of the typhoon wiped out the majority of local fishing boats, larger craft and even a number of Filipino coast guard vessels. This has not only hampered the speed of the relief effort to the Islands but has also made it very difficult for local authorities and NGO's to gain a clear picture of the urgent needs of the community.

AAI's DART leader Gordon Willcock reports from the field that: "the military has been distributing a small amount of food and water by helicopter, however, there has been a lack of organisation and sustained on-the-ground effort. We will run emergency medical clinics on the islands off the coast of Concepcion and Estancia in the coming days in order to deliver medical aid and assess the real needs of affected communities."

See diagram of Philippines: Typhoon Haiyan Humanitarian Snapshot (as of 17 Nov 2013)

 
Larry/team on route to aforementioned Island
Dr. Brad ching conducting clinic on Island

 

17 Nov- AAI conducted mobile medical clinics and assessments along the east coast of Panay Island

AAI conducted mobile medical clinics and assessments along the east coast of Panay Island - as far north as Estancia. There was major damage between Concepcion and Estancia. However, the local healthcare system is holding up well and assessed as no urgent need. Access to food and a regular supply of medicines is the major concern.

AAI have been requested to go out to the Islands off the coast of Concepcion with local medical contacts to assess and conduct mobile clinics. If there is a greater need on these islands along the east coast of Panay AAI may establish a system of mobile Island clinics.

AAI have been pleasantly suprised with the level of community organisation and the rapid move to a recovery phase. The major challenges are food and water.

AAIs longer term plan is to move the response area of operations further north in order to establish staging area and longer term base.

 
Clinic on devistated island
Emergency nurse emma childs treating patients

 

Nov 15 - The challenge of getting help to the most vulnerable and remote

Access Aid International (AAI) has deployed a Disaster Assessment and Response Team (DART) consisting of disaster managers, nurses and doctors to help provide much needed medical care to people living in the remotest and most isolated areas of typhoon-devastated Philippines.

The team will determine where healthcare is most urgently needed in liaison with local authorities.

“We know there are still some remote communities cut off from the main relief effort,” AAI Director Frank Tyler said.

“Roads have been destroyed, and some small villages are simply too remote to access by vehicle or air,” Mr Tyler said.

“These people are in similar circumstances to what we’re seeing elsewhere in the Philippines but getting help to them is a lot trickier.”

The AAI Australian personnel will join a team from the United States to bring much-needed medicine, equipment and expertise direct to the remote communities.

AAI is working in partnership with Direct Relief, which provides the emergency medical supplies, including backpacks which contain everything needed to carry out life-saving medical procedures and primary healthcare on the ground in remote communities.

Joe Harrison and Andrew MacCalla from Direct Relief preparing the emergency medical packs AAI personnel will take to remote Philippines communities.

Donate to the Typhoon Haiyan Appeal

20 August, 2013

This is the thirteenth tropical storm to strike the Philippines this year.  Fortunately the death toll has been limited, but damage to schools, government offices and businesses has been significant.  The Government is leading response efforts in all affected areas.  The Philippines has about 20 tropic storms each year causing significant levels of damage.  AAI continues to work with local partners to assess needs and assist where possible.

Read More>

4 July, 2013

The National Disaster Risk Reduction and Management Council and the Philippine Humanitarian Country Team completed and documented the Typhoon Bopha After Action Review/Lessons Learned Workshops and community consultations in Mindanao. Click here to download the report.

 

Jan 25 - Weekly report 22nd – 25th January 2013, Philippines Response

1.    Current humanitarian situation:

The island of Mindanao is now experiencing further stressors triggered by ongoing heavy rains over the last week. According to OCHA (Sitrep #16, 23 January) an additional 10,300 families/39,900 people, have been displaced from the Davao region due to the heavy rains. The areas worst affected are that of Davao Del Norte, Davao Oriental and Compostela Valley. Davao Oriental and Compostela Valley are not only trying to deal with this recent flooding but are still trying to recover from the acts of Typhoon Bopha. The Philippine Government continues to carry out search and rescue missions.

Due to the increasing problems and vulnerability of the already affected people, it is expected that the Davao region will experience a slowing of response activities in these areas. The extensive rains have left some roads into these areas impassable due to landslides, damaged bridges and high water levels.

According to the OCHA Sitrep No 12, as of January 21st the DOH Health Emergency Alert Reporting System shows updated figures of at least 1,146 deaths with 2,956 injured, and 834 still missing as a result of Typhoon Bopha/Pablo that struck in December. A large proportion of the 834 still missing are thought to be from New Bataan, Compostela Valley and General Santos City.

The DOH Health Emergency Alert Reporting System (HEARS) figures regarding damage as of 21 January 2013 are as follows:
•    182 health facilities have been damaged in Davao Oriental, Agusan Del Sur and Suragio del Sur  (169 in Region XI and 13 in Region 13), including:
o    1 Provincial Health Team Office (partially damaged),
o    7 hospitals (1 completely damaged, 6 partially damaged),
o    14 RHUs (4 completely damaged, 10 partially damaged)
o    160 BHSs (64 completely damaged, 96 partially damaged BHSs)
o    The estimated total cost of damage to infrastructure is PHP 410,925,000, with the estimated total cost of damage to equipment is PHP 53,645,000.

The main area for healthcare identified by OCHA is the large need for urgent provision of pre/post natal check ups, supply of ‘dignity kits’ for pregnant and lactating women as well as support for teenage pregnancies.

The need for shelter across the region also remains a key focus of reports along, with that of food security. Mindanao is one of the Philippines’ key regions for food produce and many crops have been partially if not totally destroyed. Despite efforts to re-generate crops for partial harvest, the recent flooding has caused further damage, thus affecting food availability and consumption.

The United Nations Office for the Coordination of Humanitarian Affairs have released an updated Humanitarian Action Plan: Typhoon Bopha/Pablo Response – An Action Plan for recovery;  appealing for a further $48million for assistance. See link for more information
http://philippines.humanitarianresponse.info/document/typhoon-bopha-action-plan-revised-25jan2013.

2.    Main areas of work in the last week:

Due to the lack of access for those affected by Typhoon Bopha and destruction of many health facilities in the region, AAI and Reach International have been carrying out mobile medical clinics (including minor surgeries) in the municipality of Laak. This week saw total of 634 patients between 2 Doctors and 5 nurses, with 15 surgical procedures being performed. Presenting complaints included common cough and cold, psychological trauma, hypertension and headache.

3.    Progress Made:

This was the first visit into Laak municipality for the AAI and Reach Team since the typhoons hit. Contact was made initially with the Head of Police for approval to enter the area, followed by an escort to meet with the Second in command of the military. Only then were the team allowed to enter the municipality to meet with the Municipality administrator to arrange where work was still needed. Three Barangays were identified still thought to be in need. These baranguays had in fact seen government medical attention 3 weeks prior however these were 3-minute consults. Clinics were carried out in a school classroom and town halls.

4.    Initiatives, training and staff mentoring that increase the capacity of local staff.

On the spot training occurs for staff for any interesting clinical case.
Planned formal lecture by Dr Jessica Holden for Monday 28th with the focus of menorrhagia.

5.    Planned activities for the upcoming week.

This week will see AAI and Reach team members returning to the municipality of Monkayo where medical clinics have been carried out in some Barangays affected badly by the typhoon. We will continue to provide acute medical care.

Co-Authors: Emma Childs, Sophie Wallace and Jessica Holden
Access Aid International

January 2013

Access Aid International (AAI) were recently donated 900 waterproof sleeping mats by Platypus Outdoors Group Pty Ltd. for distribution to affected communities in Mindanao to improve their living conditions. In order to rapidly ship these goods to Mindanao, the DHL Disaster Response Team generously offered to assist AAI by shipping the mats from Melbourne to the affected areas in support of the planned distribution by Peace Builders (PBCI), a local NGO who were already well established and were providing humanitarian assistance in the affected area. A full report on this project can be downloaded HERE

AAI & DHL teams prepare sleeping mats for distribution

 

Unloading the sleeping mats with the community

 

Angel Abella (AAI) assists with community distribution

December 2012 - Emergency Response (Typhoon Bopha)

Situation - 27 December 2012

The latest OCHA Sitrep notes:

  • There have been 1067 reported deaths, 6.2 million affected people, and 178,704 houses partially or totally damaged.
  •  Presently there are 87 evacuation centres accommodating some 13,940 people, and 959,300 people are staying outside evacuation centres.
  • Over 50,000 tarpaulins are needed urgently to provide emergency shelter. Read more here

These figures are growing daily as relief efforts reach remote areas, some only accessible by foot. Access Aid International (AAI) has now deployed it’s Disaster Response and Assessment Team (DART) to provide assistance to local NGO’s in Mindanao.

The AAI DART has established a partnership with Reach International to provide medical support to previously inaccessible villages throughout Compostela Valley and Davao Oriental. These mobile clinics are predominately operated by local health professionals, supported by AAI volunteers from Australia. To enable future operations over 21,000 Pesos were donated to provide a new tyre for the team’s 4x4 and 10 new blood pressure kits.

Costa DiMeglio, a paramedic  from Sydney,  is now in the field working with the Reach International mobile clinics assisting in the treatment of acute respiratory infections, fever, skin disease, acute watery diarrhea, open wounds and bruises as the top consultations.

In addition, Platapus Outdoors Group Pty Ltd, a well known Melbourne based outfitter, has  generously donated 900 self-inflating sleeping mats to AAI for distribution in areas with little shelter. DHL’s Disaster Response Team (DRT) and the Local NGO Peacebuilders, have joined the project to provided logistical and programming assistance for future distribution to the affected communities.  AAI and the DRT have also volunteered at the Davao City Interagency Relief Center to repackage food goods to create ‘family packs’ for distribution by the Department of Social Welfare and Development over the coming days.

AAI is now preparing to surge its response to this emergency by deploying  further health teams from Australia over the coming weeks.

      AAI & DHL Team pack relief goods for distribution

Situation - 8 December 2012

AAI has commenced working with its local partners on the ground to ascertain the extent of the emergency. An assessment team has been prepared and will deploy shortly into the crisis affected area.

What is known at this time is that between 4 and 7 December 2012, Typhoon Bopha, the most powerful storm to hit the Philippines in 2012, passed through the southern Philippines from Mindanao to Palawan, making landfall three times.

Out of the 5.4 million people affected, over 540 people are dead and 827 missing. Some 368,672 people remain displaced; half of the displaced are in 173 evacuation centres; the remaining 190,871 people are staying in open areas or with family and friends. Over 46,000 houses are damaged or destroyed. Initial rapid needs assessments and government priorities indicate dire needs in food, shelter, camp management, water and sanitation, protection and restoration of livelihoods.

By Proclamation No.522 of 7 December 2012, the President officially declared a national state of calamity and accepted offers of international assistance. In support of Government efforts to respond to the immediate needs of the most affected people, US$65 million is sought to reach 481,000 people through 27 projects, implemented over a 3-6 month period.

Further details and updates are available at the UN website Humanitarian Response here

 

15 March, 2010 - AAI Finalises Projects in Laguna, Philippines

Over the course of AAI's two month project in Los Banos and surrounding municipalities, AAI and partners have been able to deliver high quality, comprehensive training and health programs. AAI has invested a significant amount of time into increasing the capacity of local Barangay Health Workers (BHWs), Barangay Nutritional Scholars (BNSs), day care workers, health officials and local NGOs. AAI has equipped training participants and the greater community with the tools and knowledge to carry forward the messages of hygiene promotion and disaster preparedness. “There is an increased awareness about disaster preparedness and hygiene and we hope that these messages will be able to be practically applied during the next disaster,” says program coordinator in the Philippines , Emma Sturrock.

The Philippines suffers from earthquakes, tsunamis, monsoons and active volcanoes. Due to the geographical location of the Philippines , it remains a country that is repeatedly prone to natural disasters. It is imperative that the population knows how to respond effectively during calamities in order to reduce mortality and to avert widespread disease.

AAI has thoroughly enjoyed working in Laguna , Philippines . The barangays (villages) have been vibrant, welcoming and appreciative. AAI's trainings have empowered communities and it has been a rewarding experience for AAI to watch communities apply what they have learned.

BHW educates children about hygiene

AAI would like to thank its wonderful partners: Christian Reformed World Relief Council, Medical Teams International as well as Direct Relief International. It is through such positive partnerships that AAI has been able to deliver a highly successful program. AAI would also like to thank its wonderful local team who have been extraordinary in mobilising communities as well as delivering training programs.

It is imperative that the population knows how to respond effectively during calamities in order to reduce mortality and to avert widespread disease. As such, there is a recognized need for ongoing disaster reduction programs in the future for the Philippines .

An end of project report will be made available in the upcoming weeks, please visit the website regularly.


10 March, 2010 - AAI Conducts Community Follow Up Visits in Victoria and Pila.

Over the past two weeks AAI has been actively conducting community follow up visits in Victoria and Pila. At the visits AAI has encouraged and supported the day care workers and Barangay Health Workers (BHWs) in their hygiene education.

                           

Interactive game for hand washing 

  Hand washing activity

The teaching resources provided by AAI have allowed day care workers and BHWs to deliver hygiene messages in innovative ways. Many of the day care workers had already used a number of the teaching tools and activities with their students prior to the follow up visits.

                                                      

Child washing his hands

 

Day care teachers and BHWs sing hand washing song at follow up visit

The follow up visits were also used as an opportunity to educate mothers of the day care children about safe hygiene practices. Many of the mothers remain outside of the day care while their child attends and therefore the BHWs provided education classes as well as involved them in the interactive activities.


4 March, 2010 - Mr. Matt MacCalla from Direct Relief International visits AAI's Hygiene Training in the Municipality of Pila, Laguna.

AAI was thrilled to have long term partner Matt MacCalla from Direct Relief International attend AAI's hygiene training on 3 March, 2010. Mr. MacCalla was visiting from the United States and was able to observe first hand the hygiene training AAI has been actively delivering as a part of its disaster preparedness and capacity building program in the Philippines.

                                                                                  

AAI nurse, Joy Bernardino explains a teaching tool for safe coughing and sneezing

 

Training participants listen to a lecture about safe hygiene practices

A total of 36 individuals attended the hygiene training in Pila, Laguna. The training was held at the municipal head office and Barangay Health Workers, Barangay Nutritional Scholars and Day Care Workers from all of the 17 Barangays in Pila were present.

                           

Matt MacCalla and Emma Weaver

 

Hygiene training participants

The municipality of Pila has expressed significant interest in the need for hygiene training as they were affected by the recent typhoons. As such, AAI will be delivering a second hygiene training on 9 March, 2010 to the Barangay Councillors of Pila. This training will develop the Barangay Councillors skills of assessing and responding to hygiene issues during disasters.

BHWs and BNSs at the completion of the training with their hygiene flip charts


2 March, 2010 - AAI Delivers Another Disaster Medicine Training to Representatives from NGO's in Los Banos and Surrounding Municipalities

On March 1 and 2 AAI delivered another Disaster Medicine training course in Los Banos. The course attracted nearly 20 NGO representatives from Los Banos and surrounding municipalities who were involved in disaster response after the typhoons in late September and October 2009.

The 2-day course was based on the material devised by Dr. Watts of AAI in early February, addressing the key priorities in the emergency phase of a disaster. Areas that were covered included the initial assessment after a disaster, measles immunisation, water and sanitation, food and nutrition, shelter and site planning, healthcare, communicable disease, public health surveillance and coordination.

                                                                                               

Participants engage in group work during the disaster medicine training

 

Participants take part in a group icebreaker activity

Thanks to AAI's positive partnership with Medical Teams International (MTI), Christian Reformed World Relief Council (CRWRC) and Direct Relief International (DRI), AAI was able to deliver this third comprehensive Disaster Medicine Training Course. The course was facilitated by Emma Sturrock, Emma Weaver, Danielle Joy Bernadino, Charity Campomanes and Maria Rosario Yan.

Overall the participants thoroughly enjoyed the style in which the course was delivered, particularly the group activity work and interactive discussion during presentations. Participants expressed their appreciation for this course and the need for this type of training amongst their NGOs. All participants were very keen to pass on the information learned to their respective NGOs and communities. One participant stated ‘we have learnt so much and we can use it for our Barangay'.

Training participants at the completion of the course


26 February, 2010 - AAI Delivers Hygiene Training in the Municipality of Victoria

AAI with support from partners, Christian Reformed World Relief Council, Medical Teams International and Direct Relief International delivered a hygiene training in Victoria, Laguna to 28 participants including 11 day care workers, 8 Barangay Health Workers (BHWs) and 9 Barangay Nutritional Scholars (BNSs). The interactive training reviewed Water, Sanitation and Hygiene (WASH) messages including safe hand washing, proper disposal of excreta and safe drinking water.

                                                                                       

Group activities as a part of the hygiene training

 

Group lecture during the hygiene training

AAI equipped participants with the knowledge and ability to promote safe WASH messages both in day to day life and during an emergency. Each Barangay was provided with a durable hygiene flip chart which will be used by the BHWs and BNSs in day cares, schools and health posts. The day care workers were provided with a resource bag to assist in hygiene eduction. UNICEF generously donated hygiene posters and flyers which are being used in the day cares of each Barangay.

                                                                                                       

Hygiene flip chat

 

Participants engage in group work during the training course

The skills learned at the training are transferable and can be applied during the next disaster. Hygiene training remains an integral part of AAI's disaster risk reduction and capacity building program as safe hygiene is a vital component in reducing morbidity and mortality.

Victoria participants at the completion of the training with their resource bags


22 February 2010 - AAI Moves Disaster Preparedness Efforts into Surrounding Municipalities - Victoria and Pila.

As a part of disaster reduction efforts, AAI moves its comprehensive hygiene trainings into the surrounding municipalities of Pila and Victoria, Laguna, as both areas were affected by the devastating typhoons in late 2009.

AAI staff have been conducting thorough assessments of the area and have been establishing relationships with key officials in both Pila and Victoria. The trainings are set to be delivered later this week and in the following week.

These two trainings will target the representative Barangay Health Workers (BHWs), Barangay Nutritional Scholars (BNSs) and Day Care Workers from each Barangay. Due to the very positive reception and need that was expressed, AAI plans to deliver a further training in Pila in early March.

                                                                                             

AAI meets with the Municipal Health Officer of Pila to arrange hygiene training.

 

AAI moves hygiene training into the municipality of Pila


16 February, 2010 - AAI delivers Another Hygiene Promotion Training Course to Daycare Workers in Los Banos, Philippines

AAI continues to deliver comprehensive hygiene promotion training in the municipality of Los Banos, which was severely affected by the devastating typhoons in September 2009 that according to WHO affected more than 4 million people.

AAI has been monitoring the effectiveness of the hygiene promotion training and doing follow-ups in the Barangay's of Los Banos to establish long-term commitment to hygiene promotion as well as to develop each Barangay's capacity respond to future disasters in the area. 

As a part of the comprehensive Community Hygiene Promotion Program, AAI delivered a hygiene promotion training course for the Day Care Workers and Barangay Nutritional Scholars of Los Banos on 16 February, 2010. The training was a huge success; 25 participants attended the training session. The day care workers were equipped with the necessary knowledge and requisites to teach key hygiene messages to children using a variety of practical tools. Each participant was given a ‘Hygiene Promotion Training Manual' devised by AAI's staff and a bag of resources to aid their teaching in the classroom. Topics covered in the training included; safe hand washing, safe disposal of excreta and safe drinking water.

This was made possible thanks to AAI's positive partnership with Christian Reformed World Relief Council (CRWRC), Medical Teams International (MTI) and Direct Relief International (DRI). Each participant also received posters and flyers with key hygiene messages donated kindly to AAI by UNICEF.


12 February, 2010 - AAI Continues Community Disaster Risk Reduction in Hygiene Promotion in Los Banos, Philippines

AAI continues to deliver hygiene promotion training in the municipality of Los Banos, which was severely affected by the devastating typhoons.

AAI has been actively delivering an ongoing hygiene program as poor health outcomes during the disaster were directly linked to a lack of knowledge of life saving hygiene practices. The hygiene program is focusing on training Barangay (village) Health Workers (BHW) and the Barangay Nutritional Scholars (BNS) to be hygiene promoters within their own Barangay. The BHW and BNS of each Barangay have been equipped with the requisite knowledge and tools to teach hygiene promotion to children in a variety of settings, which include: day-care centres, schools and evacuation centres. Hygiene promotion will reduce the risk of infectious diseases among communities after disasters, which the Philippine's archipelago experiences on a regular basis.

AAI has been supporting and monitoring day-care centres in all of the Barangay's of Los Banos in which hygiene projects were implemented. This is being conducted to ensure that the BHWs and BNSs are delivering the significant hygiene messages that were learned in AAI training courses, in an effective manner. AAI is highly experienced in hygiene promotion and the community monitoring has encouraged the BHWs and BNSs to deliver the hygiene messages through innovative and effective means. 

AAI, in the Philippines, will continue to support the BHWs and BNSs to ensure that they deliver hygiene education on a regular basis.

AAI will also be delivering hygiene training to the day care teachers of Los Banos in the upcoming weeks as well as extending its comprehensive hygiene program into additional municipalities.

AAI is also pleased to welcome a new international project coordinator, Emma Weaver, to the team in the Philippines . Emma Weaver is an International Health expert and her expertise will be used to guide future community disaster risk reduction programs.


7 February 2010 - Dr. Jennifer Watts conducts Disaster Medicine Training to representatives from local NGOs in the Philippines

On February 4 and 5, nearly 30 participants from all over the Philippines arrived in Los Banos, Laguna for a training conference in Disaster Medicine held by AAI. The training participants were all members of local NGOs that respond in the medical field following a disaster. Over 15 different local NGOs from the Philippines were represented at the conference.

Thanks to AAI's positive partnership with Medical Teams International (MTI), AAI was able to deliver a comprehensive disaster medicine conference, designed and delivered by Dr. Jennifer Watts. This training conference was also made possible due to the support from Christian Reformed World Relief Council (CRWRC) and Direct Relief International (DRI).

The disaster medicine training was a 2 day course that provided participants with information on key priorities in a disaster. Topics such as initial assessment, food and nutrition, water and sanitation, shelter and site planning, human resources, and coordination were all covered on day 1. On day 2, additional health care information was provided. The health care system, mobile medical clinics, common illnesses, communicable diseases, rapid triage skills, and public health surveillance were reviewed. The course was very interactive and the participants were involved in numerous group activities throughout the two day training course.

Overall, participants thoroughly enjoyed and appreciated the course. Hopefully they will be able to apply the tools they have learned in an actual disaster setting in the future. One participant commented, “Thank you so much. I learned many things. I hope that we will be able to apply all these effectively and efficiently during disasters and that we will be able to pass them on to others.”

Trainings, such as this one, will continue to be the focus of Australian Aid International and partners in the upcoming months in the Philippines.


 

4 February 2010 - AAI Continues to Provide Much Needed Capacity Building and Health Programs in the Laguna District, Philippines.

AAI and partners have been busy delivering a variety of programs and services. AAI in partnership with Christian Reformed World Relief Council (CRWRC), Medical Teams International (MTI) and Direct Relief International (DRI) have executed a selection of ongoing training programs including a hygiene promotion training program and a disaster medicine training course.

AAI is focusing its efforts on improving long term capacity in affected communities. “There is an ongoing need to train individuals from the Philippines so that when the next disaster hits they have the necessary tools to be more prepared to respond” says AAI's Medical Coordinator in the Philippines, Dr. Jennifer Watts. 

Communities have been very enthusiastic to AAI's training programs and there has been ongoing request to continue to provide both hygiene and disaster medicine training in the Laguna District.

On Monday 1 February, 2010, AAI conducted a Disaster Medicine training course and on 4 February, 2010 to the 5 February, 2010 AAI is running a two day conference for local NGO's and health officials on Disaster Medicine in Los Banos.

AAI has also been able to donate a large quantity of medications and supplies to Los Banos and surrounding areas. These medications will be used in medical outreach activities conducted by local health officials. AAI has also assisted in the restocking of some rural health units through similar donations. While the provision of supplies allows these units to get on their feet, there still remains an ongoing need to work with local health officials. AAI is working to ensure that communities and health workers are equipped with the right set of tools to reduce vulnerabilities during a future disaster.

AAI will continue to work closely with health workers in the upcoming months.


 

1 February 2010 - Dr. Jennifer Watts Honorary Guest at 3 rd Annual Health Summit

Dr. Jennifer Watts was invited to lecture at a Health Summit in Los Banos. Dr. Watts delivered an informative lecture about the importance of hygiene in disaster response. The attendees included the Municipal Health Officer, Mayor, Barangay Captains, Barangay Health Workers and Health Professionals of Los Banos. “It was an honour to be invited to represent AAI at such a prestigious event. I am thrilled that Los Banos is recognizing the need to learn about safe hygiene practices especially in relation to evacuation centres and disaster response”. AAI will continue to work with the municipality of Los Banos in the area of hygiene promotion and disaster preparedness in the upcoming month.


28 January, 2010 - AAI Delivers Hygiene Training to Local Barangay Health Workers in Los Banos

AAI in partnership with the Municipal Health Office of Los Banos delivered a Community Hygiene Promotion Training Course to Barangay Health Workers (BHW) from Los Banos. The training aimed to equip the Barangay Health Workers with the skills, resources and knowledge to be hygiene promoters in their Barangay (village). The training reviewed the connection between hygiene and disease, the importance of safe water, sanitation and hygiene ( WASH ) practices and the roles of a community hygiene promoter. Each BHW was provided with teaching tools to deliver hygiene messages throughout the community. This training honoured the BHWs commitment to continue to deliver ongoing hygiene promotion in daycares and schools.

AAI staff will continue to work with each Barangay and with the Municipal Health Officers. This ongoing partnership will ensure that the BHWs are well supported and are delivering effective hygiene messages.

During a disaster it is imperative to respond to the WASH sector efficiently, strategically and effectively. The BHWs are actively involved in disaster response and this training has taught them safe hygiene techniques that can be applied to evacuation centres.

Thanks to AAI's positive partnerships with Christian Reformed World Relief Council (CRWRC), Medical Teams International (MTI) and Direct Relief International (DRI), successful trainings have been delivered. AAI will continue to provide training in disaster response and hygiene in the upcoming weeks.


 

25 January 2010 - AAI Enhances Community Capacity through the Provision of Training Programs

AAI focuses on long term community development through the delivery of training programs in Los Banos and surrounding municipalities.

AAI has successfully concluded its Introduction to Clinical Performance Training Course which was delivered to local nurses. The training aimed to improve medical knowledge, history taking, diagnostic skills, and medical confidence. AAI and its partners acknowledge the importance of training local health workers so that they are equipped with the capacity and confidence to respond in a future disaster.


 

20 January 2010 - AAI Delivers High Quality Clinical Performance Training to Local Nurses

The AAI team and partners have been hard at work since arriving in Los Banos. AAI has been delivering outreach clinics and to date has delivered clinics in both the municipality of Pila and Bay, located in the Laguna district.

The team has been out doing field assessments in the Laguna district to assess the need for outreach clinics and to assess the existing health systems in each area. While some areas have recovered tremendously since water levels have receded and their homes have been rebuilt, many communities still remain affected. The loss of livelihoods will take years to rebuild.

While the Philippines transitions into the recovery phase, it is essential to train locals so that they are able to respond efficiently in the next disaster. With the assistance of Dr. Jennifer Watts from Medical Teams International (MTI), AAI is in the midst of delivering a Clinical Performance Training to local nurses.

AAI is also set to deliver a Hygiene Promotion Training next week to community health workers from Los Banos. The training is designed to train participants with the skills to be a hygienest in their community. The hygiene promoter will be responsible for disseminating hygiene messages to children and adults throughout the community and they will be trained on proper hygiene responses during emergencies.


16 January 2010 - AAI Delivers Clinic in Typhoon Affected Community

AAI in partnership with the Christian Reformed World Relief Council (CRWRC), Medical Teams International (MTI), Direct Relief International (DRI) and local partners, Christian Reformed Church in the Philippines Classis of Southern Luzon (CRC-CSL) delivered their first outreach clinic for 2010. The clinic was a great success and the medical team comprised of both local and international staff provided high quality health services to a community that was severely affected by the typhoons.

The clinic was conducted in Aplaya, Pila in the Laguna district. Approximately 5 000 individuals reside in Aplaya and as a result of the flooding 300 were displaced from their homes. AAI and partners will be returning to the area to conduct a follow up clinic in the coming week. 

While the Philippines has transitioned from the emergency phase to the recovery phase there remains an ongoing need to provide services to affected populations. AAI recognizes the ongoing need to train communities and build local capacities so that they are better able to respond to future disasters. The Philippines is made up of 7 107 islands and due its location, the country is vulnerable to typhoons, volcanic eruptions, earthquakes and other natural disasters.


 

13 January, 2010 - AAI's Medical Team Moves to Los Banos, Philippines

AAI continues to provide a longer term health program in Los Banos and surrounding municipalities in the Laguna District. Water levels have receded in the area and a number of families have left evacuation centres to live with host families. Due to crowded living conditions, strained health systems and the loss of livelihoods there remains an ongoing need to provide health services.

AAI in partnership with Christian Reform World Relief Council (CRWRC), Medical Teams International (MTI), Direct Relief International (DRI) and local partners will be focusing on delivering outreach medical clinics as well as building the capacity of local health workers and community members through the delivery of trainings. A team of international health professionals along with local partners will be delivering trainings in the areas of: Hygiene Promotion, Disaster Medicine and Introduction to Humanitarian Operations.


 

19 December 2009 - AAI on Standby to Respond to the Philippines Most Recent Threat: Mayon Volcano

Just months after being hit with a number of fatal typhoons, the Philippines is faced with another pending disaster. Ten of thousands of individuals have been forced to evacuate their homes due to Mayon Volcano showing signs of increased activity.

Mayon Volcano is located in the province of Albay , in the Bicol Region, on the island of Luzon . Mayon Volcano is the most active volcano in the Philippines and has erupted approximately 50 times in the last 400 years. This volcano is well known around the Philippines and the world for its perfect cone shape.

On 14 December 2009 , the Philippines Institute of Volcanology and Seismology (PHIVOLCS-DOST) raised alert levels for Mayon Volcano to Alert Level 3 which means that magma is close to the crater and hazardous explosive eruptions are imminent.

As of 18 December 2009 , the status of Mayon Volcano remained at Alert Level 3. A total of 248 volcanic quakes and tremors were documented by the seismic network. Of the 248 volcanic quakes, 50 were reported as being explosive. The volcanic explosions have produced dark grey ash that reached up to 1000 metres above the summit before it drifted southwest.

Households within a 6km radius of the volcano have been forced to evacuate their homes and are residing in evacuation centres. As of 18 December 2009 , 38 528 individuals had been evacuated.

AAI has been assessing the recent situation and is on stand by to respond if humanitarian assistance is needed. AAI has been actively involved in providing much needed medical aid in the Philippines since the typhoons.


6 December, 2009 - AAI Remains Dedicated to Improving Health in the Philippines

Australian Aid International (AAI) and partners, the Republic of Philippines United Nations White Helmets (RP-UNWH) and the Civil Defense Action Group (CDAG), supported by the Christian Reform World Relief Council (CRWRC) and Direct Relief International (DRI) continue to conduct emergency healthcare operations in collaboration with the Department of Health of the Republic of Philippines (DoH) in the Laguna District.

The Laguna District remains one of the most affected and in need areas devastated by the recent spate of typhoons. AAI has been supporting the DoH by providing assistance to local Municipal Health Officers through the provision of outreach and mobile primary healthcare clinics.

There remains an ongoing need for humanitarian support in the Philippines for those communities who remain displaced, are still living in submerged areas and remain isolated due to landslides. It has been reported by the United Nations Office for the Coordination of Humanitarian Affairs that over 300 000 houses have been damaged by the string of typhoons.

Alongside the need for shelter there is an immediate need of addressing access to safe water and sanitation facilities, particularly in relocation camps and in residential areas affected by the floods. There is a critical need to direct attention towards improving drainage, waste collection and vector control since flood waters still remain in some areas.

As the emergency period is now transitioning to the early recovery and rehabilitation phase of the humanitarian response, AAI will focus on i mproving the capacity of local municipal health officials through the provision of training particularly in the area of disease surveillance and disaster risk reduction. There remains an urgent need to strengthen disease surveillance and reporting systems in order to reduce further disease outbreaks. There has been an outbreak of Leptospirosis since the typhoons and over 3 350 cases have been confirmed and almost 250 deaths have resulted.

Target populations remain exposed to outbreaks of infectious diseases and have far less access to primary healthcare then prior to the typhoons. This is compounded with the fact that their livelihoods have been destroyed and most beneficiaries have limited funds to pay for healthcare within the normal routine healthcare system.

AAI has established clinics in areas where local medical professionals have been overwhelmed. AAI's clinics reduce the demand on secondary healthcare facilities as well as develop the capabilities of local healthcare staff so that they can provide sustainable healthcare management within the community, with the aim of minimising the need for outside interventions.

In upcoming months, AAI will work to increase access to curative and preventative healthcare services to vulnerable populations. AAI will continue to provide education on early warning disease surveillance and capacity building of local healthcare workers in international disaster medicine. Through capacity building strategies AAI and partners hope to increase the abilities of local healthcare workers by improving their clinical knowledge, health promotional and organizational skills.

AAI has also been involved in providing effective Water, Sanitation and Hygiene (WASH) initiatives through the provision of hygiene promotion and safe water supply activities. AAI and partners have facilitated a hygiene promotion training course. The course was conducted in collaboration with the Swiss Foundation for Mine Action (FSD) and the Republic of Philippines United Nations White Helmets and Civil Defence Action Group. The training course prepares selected volunteers to undertake hygiene promotion activities within affected communities. AAI will continue to provide WASH initiatives including hygiene promotion training in aim of reducing further disease outbreaks.

AAI recognizes the ongoing need to provide medical aid and humanitarian assistance in the Philippines. AAI and its partners will continue to provide ongoing services into the New Year, however in order to provide much needed medical support, AAI requires ongoing financial support. Consider supporting AAI and their operations in the Philippines this holiday season by donating today.


20 November 2009 - AAI First to Deliver Care to the Remote Area of Majayjay

The Philippines is struggling to recover due to funding shortfalls. The United Nations (UN) has warned that the lack of funding to help the Philippines will lead to serious health risks and food security problems. AAI recognizes the vital need to continue to deliver medical aid however a long term response is being restricted due to funding limitations.

                                                                                                          

Flash flooding damage to vulnerable families living along the river in Majayjay

  An inprovised crossing to replace a destroyed bridge

At present, AAI continue to provide much needed outreach and mobile medical clinics in collaboration with local partners the Republic of Philippines United Nations White Helmets (RP-UNWH), the Civil Defence Action Group (CDAG), Knightsbridge International (KBI) as well as Direct Relief International (DRI) and the Christian Reformed World Relief Committee (CRWRC) who have been providing medical supplies.

                                                                                                                 

Homes along this river were completely destroyed by the flash flooding caused from typhoon Santi

 

AAI with local partners RPUNWH-CDAG meed the Govoner of Laguna

Many thousands of people remain displaced, living in crowded camps and not likely to return to their homes for many more months. It is important that AAI continues to provide regular medical services to these vulnerable populations who are suffering due to their living conditions and their loss of livelihoods. AAI continues to conduct infectious disease surveillance on common diseases which could outbreak in such crowded living conditions.

                                                            

AAI medical teams using much needed antiboitic creams donated by DRI

 

AAI local nurses assess an infant before referring the child to the AAI doctors

As well as concentrating on the Western Laguna area around Binan, AAI was requested by the Governor of Laguna to provide medical care to the many thousands of affected people living in the mountainous area of Majayjay, located to the South of Laguna. In this area people remain displaced due to the flash flooding of mountain rivers caused by typhoon Shanti. Due to the remoteness of this area, made even worse by the destruction of bridges, the population has lacked adequate medical services and AAI was the first organisation to provide medical services to this community.

                                                                                                                        

AAI local nurse conducts triage at an outreach clinic where hundreds of patients are being seen

 

AAI local doctor and staff treating patients at an outreach clinic

 


12 November 2009 - AAI and Partners Direct Attention to the Water, Sanitation and Hygiene (WASH) Sector

The Philippines continues to recover after being hit with a string of bad luck. Four devastating typhoons have swept through the Philippines including: Tropical Storm Ketsana, Typhoon Parma, Typhoon Lupit and Typhoon Mirinae. The storms have affected almost 10 million people and over 112 thousand people remain displaced. The remaining flood waters in many areas are making the recovery process very difficult as well as perpetuating the ongoing risk and reality of infectious disease outbreaks.

AAI has been directing its attention to the Laguna District as it has been assessed as one of the most affected and needy areas devastated by the recent spate of typhoons. AAI has been working in partnership with the Republic of Philippines United Nations White Helmets (RP-UNWH), the Civil Defence Action Group (CDAG) and Knightsbridge International (KBI) and together they have been providing emergency healthcare outreach and mobile medical clinics. Direct Relief International (DRI) and the Christian Reformed World Relief Committee (CRWRC) have assisted in the provision of much needed medical supplies and resources which has enabled AAI to provide high quality and successful medical clinics.

                                                                                           

AAI medic and Frank Tyler explain the medication to a patient

 

Patients being treated at AAI mobile medical clinic

AAI is currently training local partners in International Disaster Medical Management. The training of healthcare volunteers is focused on improving clinical, health promotional and organizational skills including: improving clinical proficiency and knowledge, enhancing clinical organization, providing reference tools and resources and improving surveillance data collection which will assist in identifying a potential infectious disease outbreak.

                                                                                 

Frank Tyler consults with patients at AAI's mobile medical clinic

 

AAI medics continue to see patients

Communicable diseases are a pressing reality due to the remaining flood waters and overburdened healthcare system. A Leptospirosis epidemic has been declared with cumulative cases since the disasters now reaching over 3 100 cases. This disease which can destroy the kidney and liver is caused by wading through contaminated water. There is also the impending threat of an outbreak of vector-borne diseases including malaria and dengue fever. The flooding washed out mosquito breeding but breeding will recommence as soon as the waters recede.

                                           

AAI medics continue to see patients 

  Patients wait at AAI mobile medical clinic

Thousands of families are now exposed to water-borne diseases as the flood waters become more polluted with garbage, human excreta and sewage. Fungal skin infections are the most common complaints at present, followed by diarrhoea and common colds – all of which can be attributed to the contaminated water.

Access to adequate water and sanitation services is difficult for poor families in affected areas due to ongoing flooding. Government authorities are struggling with the provision of sufficient services in the priority areas of water, sanitation and hygiene ( WASH ); including safe disposal of excreta and the provision of large quantities of improved drinking water. Those who fled their submerged houses are now living in temporary shelters and have been experiencing very poor living conditions. Those who stayed in their houses have even more difficulty accessing adequate WASH.

Of all the problems caused by the typhoons, the WASH Sector is the single greatest challenge facing the government. The health care system is over burdened by a chronic shortage of beds and supplies. The added burden of the Leptospirosis epidemic and looming malaria and dengue outbreaks has overwhelmed the system and the provision of hygiene promotion activities is the one key intervention that the government warmly welcomes as they are aware that hygiene problems far exceeds their capacity to cope.

In response, AAI has concentrated its attention on the WASH sector. The AAI/RPUNWH/CDAG/KBI partnership in collaboration with the Foundation-Suisse de Déminage (FSD) has started a hygiene promotion project. AAI and its partners facilitated an Introduction to Emergency Hygiene Promotion Training Course (IEHP) in Manila , Philippines. Skilled volunteers have been trained in hygiene promotion and they will work alongside medical volunteers who specialize in the provision of disaster medicine.

                                                                                                           

Presentation during the Introduction to Emergency Hygiene Training Course

  

FSD facilitator and CDAG Team

 

Student Presentation

 

Student Presentation

 

FSD Participants

 

HP Participants

 


2 November, 2009

The Philippines continues to recover after being hit by a fourth devastating typhoon which has caused widespread damage and destruction to communities already reeling from previous typhoons.

The Philippines has been hit with four Typhoons in the past month. The most recent storm, Typhoon Mirinae followed the same route as Tropical Storm Ketsana and forced thousands of people to evacuate their homes. The four storms have affected more than 9 million people and it has been reported that 123 416 people still remain in evacuation centres. There is fear that rains from the most recent storm may unleash rivers of mud and volcanic rock from the most active volcano in the Philippines located in Albay province. This has the potential to cause additional destruction and death.

                                                                                                                                

AAI's local nurse Merica taking a boat with medical supplies through flooded streets to conduct medical clinics to isoated communities.

     

Frank Tyler walks through foul flood waters to provide urgently needed medical clinics.

Communities living in flood waters and in emergency camps are under the constant threat of infectious disease outbreaks caused by the interruption of safe water and sanitation systems. Leptospirosis, a disease contracted from people living in the floodwaters, is already in outbreak proportions. It was confirmed on 27 October, 2009 that the national total for Leptospirosis was 2 894 cases with 210 fatalities since the disasters. Cholera and other devastating diarrheal diseases could occur at anytime and AAI is working hard to identify potential outbreaks through regular healthcare clinics and providing prevention activities alongside water, sanitation and hygiene (WASH) projects. It has been reported that in evacuation facilities the top five morbidities that are being presented include: acute respiratory illness, skin infection/wounds, acute gastroenteritis, influenza-like illness and severe acute respiratory illness/pneumonia.

AAI continues to provide outreach and mobile medical clinics in some of the worst affected communities. These communities have been severely affected by typhoon Ketsana and remain submerged due to the flooding of Lake Laguna. The constant barrage of typhoons has meant that there has been no immediate decrease in flood waters.

                                                                                                             

Local nurse Chileen incises and drains many of the infected wounds that patients are suffering from exposure to flood waters.

 

New AAI Philippines medical coordinator Richard Zoraster discusses the treatment plan of an ill infant. 

The large number of people requiring healthcare is presently overwhelming an already struggling local healthcare system. AAI is setting up a longer term health project plan to ensure that those communities affected by the typhoons have continued access to primary healthcare services whilst they are displaced.

Along with local partner, the Republic of Philippines United Nations White Helmets (RP UN WH) , Knightsbridge International (KBI) and the Civil Defence Action Group (CDAG) AAI has now partnered with a Swiss NGO Foundation- Suisse de Déminage (FSD). AAI and FSD will be one of the first in the area to commence a UNICEF course to conduct water and hygiene programs in selected communities. The hygiene promoters will come from the hundreds of locally based volunteers already supporting AAI.

                                                            

Patients are triaged before entering the AAI clinic.

 

Patients treated at a AAI clinic.

AAI's mobile and medical clinics have been supported by Direct Relief International (DRI). DRI has been providing much needed medical supplies and these supplies have allowed AAI to run successful clinics and to treat hundreds of patients in need of medical attention. DRI has been a reliable and positive partner for AAI.

AAI has also established a new partnership with the Christian Reformed World Relief Committee (CRWRC). CRWRC will assist AAI with their healthcare clinics through the provision of medical supplies and resources. AAI will be able expand their clinics to provide more services in more affected communities.

The combined efforts of AAI, RPUNWH/CDAG, DRI and CRWRC means that AAI will be able to continue to deliver high quality and effective health services to some of the most affected communities in the Philippines.


22 October, 2009 - AAI Continues to Provide Disaster Response Medical Aid in the Philippines as the Flood Emergency Continues.

As the threat of deadly infectious disease outbreaks increases and every new day brings the possibility of the onslaught of new typhoons, AAI continues to provide medical assistance and monitoring in flood devastated areas.

Each day brings a fresh alert of another destructive typhoon roaring towards the country. These new typhoons herald the possibility of further damage to communities which are already struggling to cope with the ongoing disaster. The disaster affected populations are living in flooded towns and villages and in displaced persons camps. Any threat of further rain and flooding causes major concerns as water is unable to drain from the population areas.

The number of those affected by these horrific natural disasters continues to climb. On 21 October it was reported by the World Health Organization Philippines that 8 769 252 individuals had been affected and 864 had died.

                                                                      

AAI providing healthcare clinics to victims of the typhoon.

 

Dr Dan and nurse Chileen assessing a patient.

The Filipino Government is doing everything it can to avert disaster however, their ability to respond and assist the many victims is currently stretched to the limits. International assistance to the Philippines is still vital and will remain so for at least the next six months as the country remains in the emergency phase of the humanitarian relief operation. The emergency phase continues in the Philippines due to the sheer numbers of affected people who are unable to return to their homes or who are living in the floodwaters.

The threat of severe infectious disease outbreaks remains the major concern. Leptospirosis, a disease caused from the foul floodwaters has now reached the epidemic threshold with thousands of people infected. This disease can quickly lead to severe conditions and 10% of those infected are likely to die form the condition. Without early detection and treatment, the country's healthcare system will be unable to cope with this level of infection which is currently not being experienced anywhere else in the world. Other infectious diseases also remain a threat. Outbreaks of dysentery, cholera and dengue fever remain a distinct possibility.

                                                                                                

Dr Dan cleaning an infected wound on a patients scalp.

 

Dr Richard discusses the health situation at a clinic conducted in one of the flooded communities.

AAI is contributing to mitigating the effects of infectious disease by providing urgently needed outreach and mobile medical clinics in collaboration with government health officials. AAI's Outreach Medical Clinics act as an early warning system to identify trends in infectious diseases and to provide an urgent medical response if outbreaks are identified. AAI continues to work closely with the Republic of Philippines United Nations White Helmets Knightsbridge, International (KBI) and Direct Relief International who are providing much needed medicine and equipment to the teams in the field.

Complete health systems have been destroyed and as a result, AAI's provision of medical assistance is vital. It has been reported that Tropical Storm Ketsana and Typhoon Parma have caused USD 32.5 million in damage to health facilities. Debilitated health systems coupled with ongoing flooding and the threat of pending typhoons place the health of the population in an ongoing compromised state.

Frank Tyler assesses patients with local nurse Chileen

 

AAI is currently concentrating activities in the Binyan municipality of Laguna which is one of the most devastated areas of Manila and which contains a large population who remain living in the dangerous floodwaters.


21 October 2009 - AAI Director of Operations, Frank Tyler, is awarded one of the Philippines Highest Honours.

Frank Tyler has been inducted into the Order of the Knights of Rizal in recognition for his humanitarian assistance to the Republic of Philippines .

The Order of the Knights of Rizal was established on the 30 th of December 1911 to recognise those who have made an outstanding contribution to peace and humanity. The honour is named after Dr. Jose Rizal whose teaching and writing inspired and united the Filipino people against colonial rule – Rizal was executed by Spanish firing squad on the 30th of December 1896.

Membership in the Order of the Knights of Rizal is strictly by invitation only and AAI's Frank Tyler joins an important list of members including Joan Carlos I, King of Spain.

Australian Aid International congratulates Frank for this outstanding achievement and for his continued commitment to international humanitarian relief work.

AAI also congratulates its Disaster Assessment Response Team (DART) for being inducted into the commissioned ranks of the Republic of Philippines United Nations White Helmets (RP UNWH). Jamin Mulvey, Dan Khodabahsh, Don Fontenot, Gordon Willcock and Frank Tyler were all honoured by Colonel Mareno of the RP UNWH. The RP UNWH is a United Nations volunteer organisation which responds to man-made and natural disasters. The RP UNWH have been a vital partner for AAI in the Philippines and we will continue to work together to assist those in need.

                                                                                                                                                                                                                          
The AAI Disaster and Assessment Response Team (DART) are honoured by being inducted into the commissioned ranks of the Republic of Philippines United Nations White Helmets (RP UNWH).  

AAI Director of Operations, Frank Tyler, is honoured by Colonel Ramon Mareno from the RP UNWH with the medal of the Knights of Razal, one of the Philippines highest honours.


15 October, 2009 - Two hundred people are Missing or Presumed Dead in Mountainous Benquet Province as Torrential Rain from Typhoon Parma Creates a Landslide Emergency.

The devastation from Tropical Storm Ketsana and Typhoon Parma is monumental. On 15 October, 2009 it was confirmed by the World Health Organization Philippines that 7 478 292 people had been affected, 336 545 people had been displaced and 823 had died. These numbers present as significant figures when compared to other natural disasters. In comparison, the Padang Earthquake that struck on 18 September, 2009 has claimed between 800 and 1 000 lives, destroyed almost 200 000 homes and has affected 1 250 000 people. The number of people affected in the Philippines equates to nearly six times the number of those affected in Indonesia .

Continuing torrential rain in North Luzon, Philippines has lead to devastating landslides in the Cordillera Mountain range. Having moved north to the flood affected province of Pangasinan to conduct outreach medical clinics, the AAI Disaster Assessment and Response Team (DART) was well placed to deploy high into the Cordillera Mountains to conduct an emergency forward assessment of the landslide affected Province of Benguet.

                                                                                                     

Dan inspects the devastation of the landslide in La Trinidad.

 

This twisted wreck of a car is an indication of the sheer power of the landslide.

The AAI DART team in cooperation with the Republic of Philippines United Nations White Helmets (RP UNWH) and Knightsbridge International (KBI) are amongst the first relief organisations from outside the Cordillera region to make it into the affected areas. The main road into the mountainous Benguet Province was cut-off by numerous landslides late last week and has only recently been reopened. The DART team has reported having to negotiate numerous landslides which have cut power lines, destroyed cars and in some places crushed buildings. Military engineers have cleared enough room along the road for vehicles to pass. The AAI team has reported that in some sections parts of the road have fallen away into the valley below and the mud from the landslides is higher than their vehicles in other places.

The most deadly landslide occurred in the Municipality of La Trinidad . This landslide engulfed and erased a large section of the village of Puguis as the mountainside above it slid into the valley floor below. The DART team, after conducting their assessment reports that all that is left at the landslide site is a river of mud. Some car bodies, their chassis twisted like wire and a house on its side half buried in the mud were the only indication of a village previously existing there. Police and military search teams are working tirelessly to locate bodies - the chance of finding survivors is remote. The Puguis landslide has claimed 111 lives, with 196 dead in the Province and 17 still missing but presumed dead.

                                                                                                                                                       

Don examines a sick boy’s eyes for signs of Leptospirosis in the Province of Pangasinan. Leptospirosis has already killed over one hundred people.

 

Don does triage at the Canlalay Elementary School Evacuation Centre in Binyan Laguna which is housing 1475 flood evacuees.

The DART team has also done an assessment of the Evacuation Centre at the Puguis Elementary School and reports that the local authorities are managing medical and food relief well. The AAI team has assessed that the biggest need for the 468 landslide victims living at the Evacuation Centre is shelter.

To fulfil this need, AAI and the RP UNWH are cooperating with ShelterBOX and Rotary International who are working to provide much needed shelter throughout the disaster zones. AAI also continues to work closely with Direct Relief International (DRI) who is providing much needed medical supplies and equipment. Their support on this operation has allowed AAI to provide much needed medical treatment to vulnerable populations.


14 October, 2009 - Typhoon Parma Has Created another Major Disaster in the Philippines while the Country Struggles to Cope with the Initial Typhoon Ketsana Relief Effort.

The AAI Disaster Assessment and Response Team (DART) in cooperation with local partners, the Republic of Philippines United Nations White Helmets (RP UNWH), Knightsbridge International (KBI) and the Civil Defence Action Group (CDAG) are amongst the first medical relief teams to gain access and provide aid to the flooded Province of Pangasinan .

Tropical storm Ketsana and Typhoon Parma have affected over 7 million individuals and have displaced over 300 000 people. These dramatic numbers dictate a critical need for the provision of health services and outreach clinics. The AAI DART team has set up outreach medical clinics 200km north of Manila to provide critical medical aid to those in the Province of Pangasinan who have witnessed continual flooding due to Typhoon Parma.

                                                                         

The deadly landslide through the village of Pugius left nothing standing.

 

Police search for bodies in the aftermath of the La Trinidad landslide.

The AAI DART team, after consultations with local authorities in the Municipality of Mangaldan, has brought much needed medical aid to flood victims in the village of Navaluan . The provision of medical supplies and equipment from Direct Relief International (DRI) has allowed AAI's DART team to run effective outreach clinics. With rain continuing until the end of last week, and with roads cut off to Pangasinan, the AAI team assessed and determined that there was a need to move north and provide medical aid as soon as the roads reopened.

The DART team has conducted successful outreach medical clinics in Mangaldan and has found the flood victims to be resilient in the face of disaster. AAI, in cooperation with local partners is continuing to provide medical assistance while closely monitoring for any outbreaks of disease in the flood affected areas. This has become more important with the confirmed outbreaks of both acute watery diarrhoea and Leptospirosis which if left untreated can lead to kidney failure. Leptospirosis is now considered a major disease of concern with the potential for a major outbreak if cases continue to rise.

                                                                                                                                                                                            

This is just one of many landslides that the DART team had to negotiate on their way up into the mountainous Benguet Province.

 

The landslide which flattened the village of Pugius has so far claimed 111 lives.

AAI will continue to run clinics in the most vulnerable flood hit areas providing medical assistance wherever it is needed most.


12 October 2009 - AAI's Disaster Assessment and Response Team (DART) Use Boats to Provide Critical Medical Assistance to those still in the Flood Zone

As the typhoon threat reduces, the emergency medical response in Manila and surrounding regions is quickly moving to the Recovery and Post-Emergency Phase (PEP). AAI's DART team is continuing to provide much needed medical assistance and assessment, seeking out those most vulnerable in areas that have yet to receive adequate medical help.

                                                                                                                                            

Dr. Dan inspects a little girl with suspected lower respiratory problems in the AAI outreach clinic in the suburb of Landayan.

 

Don and the rest of the team inspect the flood waters from a Zodiac inflatable boat.

After a number of days running outreach clinics in the flood affected Landayan Barangay (Suburb) in the city of San Pedro Laguna , the AAI DART team has assessed there is need elsewhere and has relocated south to Barangay Malaban in the City of Binyan Laguna . The DART team has been following a dual strategy of assistance and forward assessment. On the ground, this means running much needed outreach medical clinics whilst also pushing further into the flood affected region in search of the next area to provide medical assistance.

                                                                                                                                                                                                                             

Jamin and Gordo conducting an assessment of the flooded Malaban East School. Seventy eight families have been forced to take up residence in the small classrooms.

 

Dr. Jamin treats an elderly woman at an AAI outreach clinic in the city of San Pedro Laguna.

The AAI DART team, using local boats in Malaban, has responded to those still in the flood zone. Dr. Jamin Mulvey has reported that upon arriving in Malaban, the DART team was informed by locals that there were over 300 people sheltering in a small school with many young children in need of medical aid. The team responded quickly, using boats to locate the school before setting up a medical clinic for the 78 families there. Local teacher Narissa Machado said that the flooding was the “worst she had ever seen, worse than the floods of 1972” – over 90 percent of Malaban is covered in flood water.

                                                                                                                                                                                                                                                                    

The AAI team report that locals are using whatever they can find to create makeshift rafts to carry people and possessions out of the affected areas.

 

Life goes on in the flood zone – The suburb of Malaban, one hour’s drive south-east of Manila.

The DART team continues to closely monitor for outbreaks of communicable diseases which have the potential to cause further deaths in the flood affected region. With flood waters not likely to recede for some months, and with people living in or around the flooded areas, there is a genuine need to continue monitoring and treating flood victims in outreach medical clinics in order to prevent disease outbreaks.

AAI's DART team has been working closely with local partner groups headed by the Republic of Philippines United Nations White Helmets (RP UNWH) and Knightsbridge International (KBI) . The RP UNWH are a self funded group and have been a vital part of AAI's Operation Ketsana response. They have provided AAI with operational support, high level government and local coordination and a network of experienced field rescue volunteers who have been working tirelessly since the beginning of the disaster.

                                                                                                                                   

A local man moves his bicycle through the flood waters.

 

Director of Operations Frank Tyler supervises the care of a child suffering the affects of poor public health in displaced persons camps.

AAI is also closely aligned with partner organization Direct Relief International (DRI). They are providing vital supplies to outreach clinics in the disaster zone, without which AAI's doctors and nurses could not adequately respond to crises in the field. The provision of supplies has allowed AAI to respond to the disaster in a prepared and professional manner.

The AAI DART team will continue its dual strategy in the Laguna region, conducting medical assessments and running outreach medical clinics to aid those affected by the flooding and to prevent the outbreak of communicable diseases.


 

9 October 2009 - AAI Continues To Provide Medical Treatment To Countless Flood Victims

Water levels throughout Manila and surrounding areas remain high days after the typhoons struck. Communities are trying to resume life as it was before the floods but the destruction and devastation is a present and ongoing reality for countless millions. Many communities will remain flooded for months to come.

AAI has a dedicated and skilled team on the ground and continues to deliver much needed medical treatment, sanitation programs and outreach services in the area of Landayan. AAI has been able to provide high quality medical treatment and support to vulnerable and affected populations with the help of partner organisation Direct Relief International (DRI) and local partners in the Philippines.

Unclean flood water coupled with damaged water and sanitation infrastructure translates into a high risk for an infectious disease outbreak. Waterborne diseases can be fatal and have the ability to impact mass populations. AAI is working to help minimize this risk. The most common communicable diseases presenting themselves at this point include and are not limited to: upper respiratory tract infection, fever, skin disease, wounds which become infected and diarrhea.

                                                                                                                                                                               

A once normal street is now flooded with buildings destroyed and peoples homes and livelihoods possibly lost forever.

           

Gordon and Frank assessing the flood damage in the vacinity of Landayan.


7 October 2009 - AAI Disaster Response and Assessment Team (DART) Is Providing Medical Treatment and Aid To Flood Victims Right on the High Water Line.

The string of typhoons which have threatened to disrupt relief efforts in the flood affected areas of greater Manila have luckily made landfall to the north. AAI's DART team has set-up and are successfully running their outreach medical clinics in one of the worst flood affected and least accessible areas within the City of San Pedro Laguna which is a two and half hour's drive South-East of Manila. The number of individuals affected by the flooding in this region alone is in excess of 2.25 million.

The DART team has conducted forward medical assessments from AAI's outreach clinic via boat in the vicinity of Landayan and have reported that the waters remain a number of meters deep with many people refusing to leave there homes. Those staying in affected areas are living on roofs, top-storeys of houses or on anything they can find. During the calm weather of the last two days, flood victims have been moving belongings to higher ground on make-shift rafts or by wading through the chest deep filthy water.

                                                                                                                                                                            

AAI's head nurse in the Philippines, Don Fontenot explains dosage instructions to the mother of a sick girl in our Landayan outreach clinic.

                           

AAI in the devastated areas conducting mobile medical clinics to populations living in the flood waters.

The AAI doctors and nurses have been working hard diagnosing and treating a large number of flood victims. The sheer numbers housed in the various Evacuation Centres has meant they have had to first prioritize those most vulnerable including young children and older populations.

The urgency of AAI's medical response is aimed at preventing the outbreak of communicable diseases which have the potential to spread throughout the affected areas, causing another major humanitarian disaster. The major communicable diseases that are presenting themselves include: upper respiratory tract infection, fever, skin disease, infected wounds and diarrhoea. These diseases are a genuine threat throughout the flood affected areas as there is a lack of clean water, sanitation and shelter for those who have been displaced.

A fundamental part of AAI's ability to effectively diagnose and treat patients in our outreach clinics is the unabated supply of much needed medical equipment. To achieve this, AAI is working closely with sponsor organisation Direct Relief International (DRI). DRI has continually supported AAI's relief operations with vital medical supplies and equipment, allowing AAI teams to conduct their medical response with great success.

AAI's DART team will continue to diagnose and treat people at our clinic in the City of San Pedro Laguna and they are continually sending out medical assessment teams out to identify those areas which are most vulnerable and in greatest need of medical assistance.

                                                                                                                                                        

Frank in discussion with Colonel Ramon from the RP UN White Helmets about the extent of devastation.

 

Extent of the flooding can be seen by the depth of the water ten days after the flooding.


5 October 2009 - AAI's Disaster Response and Assessment Team (DART) Provides Much Needed Aid in the Philippines.

Typhoon Ketsana and Typhoon Parma have left Manila and surrounding areas in the Philippines submerged in water. The aggressive typhoons have caused extensive damage and death. The death toll continues to rise with over 300 people being confirmed dead. The numbers of displaced and affected people has soared to well over 3 million.

Health authorities are concerned about the outbreak of infectious diseases due to deteriorated infrastructure, sanitation and hygiene systems. Mudslides and continual rains will exacerbate the already fatal situation.

AAI's DART team is on the ground in Manila . AAI is working closely with partner organisation DRI to send urgently needed medical supplies to disaster areas. AAI has joined relief efforts with long term local partner organisations Knightsbridge International (http://currentmissions.blogspot.com/), and the Philippines UN White Helmets who have been on the ground providing assistance within 24 hours of the disaster occurring.

AAI's DART team is providing Emergency Disaster Expertise. With the help of partner organisation DRI and local NGO's AAI will provide mobile clinics to treat those affected. AAI is also working to avoid disease outbreaks by implementing a water and sanitation program.

                                                                                                                                                                  

As the local population are forced to live and move about the flooded areas the risk of polluted waters causing outbreaks of infections grows everyday

 

AAI medical staff consult with and provide expertise to local health teams providing outreach clinics in IDP camps


2 October 2009 - AAI's Disaster Response and Assessment Team (DART) Departs to the Philippines to Provide Much Needed Aid.

The death toll continues to rise in Manila and surrounding areas. As of today, over 240 people have been confirmed dead. The numbers of displaced and affected people has soared past 2.2 million. While aid organisations begin the long recovery process, the population has been warned of another deadly storm which is expected to strike in the next couple of days.

Health authorities remain concerned about the risk of infectious disease outbreaks caused by a break down in water and sanitation systems. Hygiene and sanitation needs to be addressed immediately to prevent the spread of communicable diseases.

AAI joined relief efforts with long term local partner organisation, Knightsbridge International (http://currentmissions.blogspot.com/) and the Philippines UN White Helmets. The UN White Helmets were on the ground providing assistance within 24 hours of the disaster occurring. AAI will be providing Emergency Disaster Expertise and organise medical supplies to be shipped to the disaster areas.

Local organisations helping AAI include Knightsbridge International , and the Philippines UN White Helmets.


                                                                                                                              

29 September 2009 - Tropical Storm Ondoy Response

AAI prepares to send a Disaster Response and Assessment Team to the Philippines in response to the devastating flooding from Tropical Storm Ondoy

Tropical Storm Ondoy – which is known locally as Typhoon Ketsana - hit the Philippinesprovince of Quezon province causing widespread damage, including in nearby Capital of Manila.

It has been reported that the storm has caused the worst flooding in the country in over four decades, with the deaths toll raising to over 200 to date and over 500,000 people affected and displaced, mostly in Metro Manila and surrounding provinces in southern Luzon.

The risk of outbreaks of infectious diseases is expected to be exacerbated by the widespread damage to infrastructure through flooding and mudslides, which have already buried hundreds of homes and caused widespread displacement.

AAI are preparing to deploy a Disaster Assessment and Response Team (DART) to coordinate with local partners who AAI have worked with in the past in other disaster responses in the Philippines.

<p>Access Aid International (AAI) were recently donated 900 waterproof sleeping mats by Platypus Outdoors Group Pty Ltd. for distribution to affected communities in Mindanao to improve their living conditions. In order to rapidly ship these goods to Mindanao, the DHL Disaster Response Team generously offered to assist AAI by shipping the mats from Melbourne to the affected areas in support of the planned distribution by Peace Builders (PBCI), a local NGO who were already well established and were providing humanitarian assistance in the affected area. A full report on this project can be downloaded <a href="/images/Newsroom/LatestNews/160113/Typhoon%20Bopha%20AAI%20Report%201.pdf" style="line-height: 1.3em;">HERE</a></p>
<p><img src="/images/Newsroom/LatestNews/160113/Attachment-1.jpg" border="0" title="AAI &amp; DHL teams prepare sleeping mats for distribution" width="440" height="293" style="display: block; margin-left: auto; margin-right: auto;" /></p>
<p style="text-align: center;">AAI &amp; DHL teams prepare sleeping mats for distribution</p>
<p> </p>
<p><img src="/images/Newsroom/LatestNews/160113/Start%20of%20Mat%20Distribution%20Truck.jpg" border="0" width="440" height="292" style="display: block; margin-left: auto; margin-right: auto;" /></p>
<p style="text-align: center;"> <span style="text-align: center; line-height: 1.3em;">Unloading the sleeping mats with the community</span></p>
<p style="text-align: center;"><span style="text-align: center; line-height: 1.3em;"> </span></p>
<p style="text-align: center;"><img src="/images/Newsroom/LatestNews/160113/Start%20of%20Mat%20Distribution%20with%20Angel.jpg" border="0" width="440" height="329" style="display: block; margin-left: auto; margin-right: auto;" />Angel Abella (AAI) assists with community distribution</p>
<p> </p>

AAI has been supplementing Concepcion's local health clinics with medical
assistance for a couple of
weeks now.

We have noticed that local activity has been increasing over the last few
days and many residents from
the surrounding islands have travelled to Concepcion for supplies, which
are increasingly available in
the markets now. This is also an opportunity for the islanders to access
further medicines, treatment
and medical investigations not otherwise available on the remote islands.

AAI has been able to conduct follow up consultations with patients who have
previously been seen by
our medical teams on the islands where AAI have been running outreach
medical clinics.

The health clinic at Concepcion city is staffed by two medical officers and
a complement of nurses and
midwives. These same doctors and nurses have been accompanying AAI on our
deployments to the
remote islands where AAI provides primary care to communities affected by
Super Typhoon Yolanda.

Today a case of anaphylaxis (severe life threatening allergy) was
encountered at the medical clinic. A 15
year old girl with a known previous allergy to eggs presented to the clinic
with her mother after eating
sardines potentially combined with egg. She presented with the typical
urticarial rash and then
developed difficulty breathing. The AAI team were called to assist at which
point she was quite unwell.
She required intramuscular adrenaline, intravenous fluids and oxygen. AAI
staff stabilised the patient
and managed her care as she was rushed to the nearest hospital. She has
recovered and is now well.

AAI staff has assisted with thee management of several wounds and excised
some foreign bodies and
skin lesions from several patients. These procedures would typically be
referred to the local hospital
which require transport and significant cost the patient for the surgery.

Tomorrow AAI will once again undertake an outreach clinic to the islands
surrounding Concepcion in
support of the provincial medical staff.

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