For many communities in Northern Philippines, the pounding of hammers on rooftops and cacophony of wood being sawed for walls have become as familiar as the sound of children playing.
When Typhoon Nock-Ten (local name Nina) made landfall on the evening of 25 December 2016, it damaged more than 300,000 houses, most of it located in the provinces of Camarines Sur, Albay, Catanduanes, Quezon and Marinduque.
According to the National Disaster Risk Reduction and Management Council, Nock-Ten affected more than 2 million people from almost 2,000 barangays in 15 provinces.
For Lydia Malinana, 54, the severity of the typhoon and the resulting flash flood took her and her family by surprise. "Living by the river, we always knew that it could overflow and flood our home, but I didn't expect that the house would be completely gone. We don't even have any walls left standing."
Almost 500,000 people were preemptively evacuated by the local government units, and while many are beginning the mammoth task of repairing their damaged homes, a more silent threat is looming over the typhoon-affected communities.
Typhoon Nock-Ten knocked down trees and utility poles, some of which damaged the water lines in Albay, Camarines Sur, Marinduque and Catanduanes. For communities living here, the typhoon had come after a recent diarrhoea outbreak triggered after Typhoon Sarika made landfall in the area.
According to the Catanduanes provincial health office, the damaged water sources, coupled with poor hygiene practices, have raised concerns that the outbreak would recur. The lack of proper toilets and latrines means that at least 28 percent of the population to practice open defecation.
The Philippine Red Cross, together with the Department of Health and supported by the International Federation of Red Cross and Red Crescent Societies (IFRC), rolled out a Surveillance in Post Extreme Emergencies and Disaster (SPEED) orientation to around 65 Red Cross community volunteers in three of the most affected provinces.
"Simply put, it is a community-based surveillance mechanism that ensures early detection of an increase in communicable and non-communicable disease," says Dr. Abhishek Rimal, the Health Delegate for the IFRC in the Philippines. "It enables the identification of appropriate response in preventing diseases and averting deaths. Updating the surveillance mechanism will strengthen the Red Cross' capacity to address health concerns after disasters."
The Red Cross set up a water, sanitation and hygiene promotion camp near a water source in the town of Virac. "We will be setting up other water stations in areas that have had trouble accessing clean, potable water," says Philippine Red Cross Catanduanes Chapter Administrator, Raymund Reynaldo.
As of 13 January, the Red Cross has distributed nearly 177,000 litres of potable water in the affected provinces. While conducting health and hygiene promotion activities, Red Cross volunteers also distributed over 2,500 bottles of hyposol (sodium hypochlorite solution) to help households purify and disinfect their contaminated water.
For over 200 households that live in the island of Parumpong, one of the outlying islands north of Catanduanes, while the typhoon merely grazed them, persistent rains and bad weather in the past month have made it difficult for the residents to obtain clean, drinking water.
Many of the water points that dot the islands are connected through a mix of PVC and plastic hoses, passing near or directly under areas where residents have set up pig pens and garbage dumps.
Red Cross community health volunteers like Linda Atilanan, who is also a caretaker of one of the water tanks in Parumpong island, says this compromises the safety of the water that comes out of the water points. The island is a 30-minute boat ride from the municipality of Caramoran. Filtered, clean water has to be ferried across the sea. Each jerry can of filtered water can cost anywhere from 25-35 pesos (around 0.50 - 0.70 US Dollars), and will only last a couple of days for each family.
"Many residents would rather boil their water than to spend money for filtered water," Linda explains. "We also don't have a regular nurse or midwife stationed here to provide immediate treatment to those who fall sick."
Red Cross teams have already reached the island last October to conduct assessments and an orientation on best hygiene practices after Typhoon Sarika caused heavy rains in the island. The arrival of Typhoon Nock-Ten and the effects of tropical depression Auring made the island inaccessible for weeks. Landslides, rough seas and continuing bad weather prevented the Red Cross from returning until January 14, 2017.
Lina Torres, a resident from the island says that most of their water points were submerged in floods and this has turned their water murky. "It doesn't smell, but it doesn't look clean either," says Lina. "We boil our water for 30 minutes before using it. I even boil the water my teenage son uses for bathing."
