The Impact of Typhoon Haiyan on Health Staff: a Qualitative Study in Two Hospitals in Eastern Visayas, the Philippines

Background and objective: Understanding how natural disasters affect their victims is key to improve prevention and mitigation. Typhoon Haiyan strongly hit the Philippines in 2013. In Leyte, health staff of two hospitals had a key role as responders, but also as victims. Scarce literature is available on how health staff may be affected when being disasters' victims. We therefore aimed to understand Haiyan's impact for health staff at personal and work level. Methods: We conducted semi-structured interviews in the two hospitals with doctors, nurses, midwives, watchmen and administrative staff in September 2016. We used a thematic analysis. Results: The three main aspects reported as influencing staff were accessibility, safety and emotional aspects. Accessibility was a main difficulty, which prevented some staff from reaching the hospital, causing other staff staying longer on-call. Personal and family safety were affected, and due to remaining on-call immediately after Haiyan, staff members reported lack of information about their family situation. Faith was an emotional aspect repeatedly mentioned as a coping mechanism, and commitment to serve patients was for some respondents an essential argument to stay on duty. Conclusions: Conflict between personal and professional concerns was present in health staff, making it difficult for them to prioritize work. Feeling unsafe was a common experience among health staff which influenced attendance to the hospital. Including temporary housing for staff and relatives close by the hospital can improve the extensive disaster risk during the typhoon season. In addition, established communication channels should be prioritized for staff on duty to find out about family members' wellbeing. We recommend faith and commitment to serve patients to be included in the preparedness programs in this setting

The impact of Typhoon Haiyan on admissions in two hospitals in Eastern Visayas, Philippines

We investigated the short-term impact of Typhoon Haiyan, one of the strongest typhoons ever to make landfall, on the pattern of admissions in two hospitals in Eastern Visayas, the Philippines.This study took place at Eastern Visayas Regional Medical Center (EVRMC) in Tacloban, and Ormoc District Hospital (ODH) in Ormoc. We determined whether there were differences in the pattern of admissions between the week before and the three weeks after Haiyan by using information on sex, age, diagnosis, ward and outcome at discharge from patient records.There was a drop in admissions in both hospitals after Haiyan as compared to before. Admissions climbed back to the baseline after ten days in EVRMC and after two weeks in ODH. When comparing the period after Haiyan to the period before, there was a relative increase in male versus female admissions in ODH (OR 2.8, 95%CI 1.7-4.3), but not in EVRMC. Patients aged ≥50 years and 0-14 years had the highest relative increase in admissions. There was a relative decrease in admissions for the ICD10 group 'Pregnancy, childbirth and the puerperium' (OR 0.4, 95%CI 0.3-0.6), and an increase in 'Certain infectious and parasitic diseases' (OR 2.1, 95%CI 1.2-3.5), mainly gastroenteritis, and 'Diseases of the respiratory system' (OR 1.8, 95%CI 1.0-3.0), mainly pneumonia, compared to all other diagnosis groups in ODH. Out of all reasons for admission within the study period, 66% belong to these three ICD-10 groups. Data on reasons for admission were not available for EVRMC.The observed reduction in patients after the Typhoon calls for ensuring that hospital accessibility should be protected and reinforced, especially for pregnant women, by trying to remove debris in the direct hospital vicinity. Hospitals in areas prone to tropical cyclones should be prepared to treat large numbers of patients with gastroenteritis and pneumonia, as part of their disaster plans

Measures of association for different characteristics, comparing admissions before (November 1–7) and after (November 8–30) Haiyan.

<p>Measures of association for different characteristics, comparing admissions before (November 1–7) and after (November 8–30) Haiyan.</p

Number of daily hospital admissions before and after Typhoon Haiyan (November 2013) for Eastern Visayas Regional Medical Center (EVRMC) and Ormoc District Hospital (ODH).

<p>Number of daily hospital admissions before and after Typhoon Haiyan (November 2013) for Eastern Visayas Regional Medical Center (EVRMC) and Ormoc District Hospital (ODH).</p

Weekly admissions in Eastern Visayas Regional Medical Center in terms of sex, age and ward, one week before and three weeks after Typhoon Haiyan.

<p>Weekly admissions in Eastern Visayas Regional Medical Center in terms of sex, age and ward, one week before and three weeks after Typhoon Haiyan.</p

Representation of Eastern Visayas, the area affected by Typhoon Haiyan.

<p>The study locations are indicated on the map (Ormoc District Hospital in Ormoc, and Eastern Visayas Regional Medical Center in Tacloban).</p