Philippine medical workers face derisory pay, outright hostility in a health system undermined by decades of neglect.
The coronavirus pandemic is complicating Philippine efforts to move hundreds of thousands of people into evacuation centres where social distancing is hard to enforce as a strong typhoon pummels through its eastern provinces.
Typhoon Vongfong, the first to hit the country this year, intensified after slamming into the eastern Philippines on Thursday afternoon, packing winds of 155km (96 miles) an hour and gusts of up to 255kph (158 miles an hour), the state weather bureau said in a bulletin.
Provincial and city governments, many of which are already strapped for resources due to the outbreak, are grappling with logistical and space issues, with an estimated 200,000 people needed to be moved from their homes in coastal and mountainous areas because of fears of flooding and landslides.
“This is really a nightmare for us here,” Ben Evardone, governor of the Eastern Samar province, told CNN Philippines. “Our problem right now is where to squeeze our people, while making sure they practice social distancing.”
With an average of 20 typhoons every year hitting the Philippines, an archipelago of more than 7,000 islands, the challenges faced by stretched-thin local governments offer a grim preview of disaster response in the time of COVID-19.
The Philippines was bracing for the typhoon while trying to fight the outbreak largely by locking Filipinos in their homes and prohibiting gatherings that can set off infections.
More than 11,600 COVID-19 cases, including 790 deaths, have been reported in the country.
Overcrowding in emergency shelters is a common scene in the archipelago, which is usually hit by about 20 typhoons and storms a year, and regularly experiences volcanic eruptions and earthquakes.
The typhoon was forecast to move northwestward and hit Luzon, the country’s largest island that includes the capital Manila, which remains on lockdown.
Images shared on social media showed the powerful typhoon bringing intense rain and violent winds in areas along its path, toppling trees, knocking out power and destroying homes.
In the town of Buhi in the province of Camarines Sur, hundreds of evacuees were given face masks before they were allowed in the evacuation centres.
Mark Anthony Nazarrea, a public information officer at Buhi, said the local government turned two more schools into temporary shelters to enable better social distancing.
The only evacuation centres for 8,000 villagers in Jipapad, a town in the typhoon’s path, are a gymnasium and the town hall where residents could be sheltered from the typhoon.
Mayor Benjamin Ver, who also is the town’s sole doctor, said he has secured enough face masks to protect his villagers from the virus in the town hall.
Observing social distancing “is almost impossible” if all the villagers are crammed in the town hall, but Ver said he would see what else could be done.
Jipapad and the whole of Eastern Samar, a province of half a million people, remained free of coronavirus infections unlike neighbouring regions, provincial Governor Ben Evardone said.
All emergency shelters have been turned into quarantine facilities with medical equipment in case of outbreaks but may have to be rearranged back into evacuation centres if large numbers of people need shelter, Evardone told the Associated Press.
Northern Samar provincial Governor Edwin Ongchuan said he has asked for twice the usual number of school buildings to be turned into typhoon shelters to accommodate about 80,000 residents who were being forcibly evacuated from high-risk coastal villages.
“If we used 10 school buildings before, we now need 20 to accommodate the evacuees with social distancing,” Ongchuan said.
The government weather agency warned that “along with large swells, this storm surge may cause potentially life-threatening coastal inundation”. It added that sea travel could be dangerous in regions battered by Vongfong, a Vietnamese word for wasp.