Puerto Rico: Hurricane Maria Relief
Dr. Martina Fuchs Visits to Determine Next Steps: December 2017
February 16, 2018
Edwin Rodriguez and Deanna Boulard
Summary of Activities
From December 1, 2017 to December 9, 2017, RMF Founder and CEO Dr. Martina Fuchs visited Puerto Rico with Edwin Rodriguez, whose family is from the island. The purpose of Dr. Fuchs’ visit was to follow up on the RMF team’s initial needs assessment; strengthen ties with local authorities, medical professionals, and organizations; and to decide the best way forward for RMF’s Hurricane Maria relief efforts.
After our initial needs assessment and this second visit, observing conditions and listening to and consulting with local professionals, government officials, and a FEMA representative on the ground, RMF is pursuing the following next steps for hurricane relief in Puerto Rico:
- Procuring a custom-built mobile medical vehicle to bring primary health care and health education, as well as patient transport options, to isolated communities
- Working to begin supporting a hub clinic in Vega Alta with medical supplies and human resources
- Looking to partner with another NGO to restore vulnerable community members’ access to clean water and electricity
Meeting at Ciales Mayor’s Office
Needs of the Town of Ciales
At the Ciales mayor’s office, we met with Luis Rosario, Special Assistant to the Mayor, who explained the hurricane’s impact and resulting needs of Ciales:
- The town is still 100% without power, with 90% water restored.
- Cell phone service is poor, and communication with government workers and town residents is difficult or impossible.
- Elderly and bedridden citizens are suffering the most, and they are in need of basic supplies such as adult diapers, food, light (flashlights or LED lights), and means of communication.
- Schools are only open from 8:00 AM to 12:00 PM due to no water or power.
- There are two level 1 hospitals in Ciales, and neither offers 24-hour care.
- Many government buildings and vehicles were damaged by the hurricane. The police department is working out of the second floor of the town library, and the EMS department has moved into a shared space at the firehouse. Ciales previously had 5 waste disposal trucks, and now only 2 are working. The town also has fewer functioning ambulances because of the hurricane.
Mr. Rosario requested any aid that RMF could offer the town, and stated that storage is available for goods and medicine.
Meeting at Prymed: Ciales’ Main Hospital
Needs of the Hospital
We visited the main hospital, Prymed, which serves all of Ciales. Here, we met with the administrator of the hospital, who explained the hospital’s capacity and needs:
- The hospital’s maximum capacity is 7,000 patients, but they have surpassed this number due to doctor’s offices and clinics remaining closed throughout the town.
- Prymed offers an emergency room, dental office, social workers, labs, and every other primary care need.
- The hospital is a nonprofit establishment. They treat many patients who are on government insurance, but also those who are uninsured, including patients unable to pay for services. The hospital depends on contracted ambulances.
- Currently, Prymed is the only facility in Ciales that can offer vaccines, because they have a generator to maintain the cold chain.
- The hospital is in need of medication, especially for hypertension, diabetes, COPD, and asthma.
- The hospital received some supplies from DRI.
Meeting at Vega Alta Clinic
Needs of 5 Medical Clinics
In Vega Alta, we met with Dr. Luis Gonzalez Bermudez at the Vega Alta Clinic. Dr. Luis oversees 5 medical facilities, and he described the hurricane’s impact on medical clinics in the area:
- The Vega Alta Clinic sustained structural damages, especially to the roof.
- The 5 clinics serve about 20,000 patients.
- Medications and medical supplies are needed for daily functioning of the Vega Alta Clinic, and the clinics in Dorado and Comerío are also in need of assistance.
- The clinics are in need of additional medical personnel and have only one active ambulance.
RMF is now working closely with Dr. Luis, and we have begun supporting the operations of these 5 health clinics. Through RMF, the clinics are also receiving essential medical supplies from Direct Relief International (DRI). Once full implementation begins, RMF will strengthen the clinics’ referral system and outreach capabilities by providing a medical transport vehicle/ambulance. We also plan to support the Vega Alta Clinic by providing medications and human resources; this clinic will act as a hub for medical outreach activities.
Meeting at Department of Health
Insights from the Secretary of Medical Services and Nursing
We met with the Department of Health’s Secretary of Medical Services and Nursing Yolanda Otero, who helped connect us with more medical, NGO, and engineering contacts and described needs in several areas of Puerto Rico:
- Ms. Otero explained that the town of Ciales had received a lot of federal help, but Vega Alta had not.
- She confirmed that Puerto Rico would benefit from a mobile medical and dental clinic for isolated communities.
- Ms. Otero highlighted the need for dialysis for 7 patients in Vieques (a small island east of the main island). These 7 patients currently must be transported to the main island every week. Ms. Otero also inquired whether RMF could build a health care facility for Vieques.
Meeting at Comerío Mayor’s Office
Needs of the Town of Comerío
RMF met with Carmen Pérez of the Comerío mayor’s office, who explained the effects of Hurricane Maria on the municipality:
- Comerío’s town center has power and water, but most of the town’s other areas have neither power nor water.
- 3,100 homes were destroyed in the municipality.
- Comerío’s poverty level was 70% before Hurricane Maria, and this is expected to increase dramatically when new data are taken.
- A lot of psychological impact has been observed after Hurricane Maria, including an increase in suicides, especially of bedridden persons whose quality of life declined sharply in the absence of electricity and water.
- People on federal assistance receive only $94 a month for food.
- Ms. Pérez expressed the area’s need for transportation of residents to clinics, and confirmed interest in a mobile medical and dental clinic. There is currently no mobile medical or mobile dental clinic on the island.
- She explained that a visiting nurses’ program visits 300 residents.
- Area residents are struggling with many respiratory issues; lack of power does not allow for proper treatment and mold prevention in homes.
Meeting at San Juan Convention Center
Insights from FEMA Liaison
In San Juan, we were able to meet with FEMA Voluntary Liaison Jose D. Cardona, who shared insights, contacts, and overarching concerns regarding the situation in Puerto Rico:
- Mr. Cardona explained that the biggest concerns are power, water, and medical care.
- FEMA wants to help volunteers identify the biggest needs and provide long-term solutions.
- Mr. Cardona promised to find a solar power point of contact for us, but explained that the power company has a monopoly on the island and makes it difficult to do things outside of their scope.
- He also offered to provide RMF with a contact for the Department of State and connected us with Volunteer Organizations Active in Disasters (VOAD).
- RMF was included in the portfolio of PRVOAD (Puerto Rico VOAD) on December 8, 2017.
- 1,079,000 residents have registered for FEMA assistance.
- 121,000 residents have registered for blue sheeting tarps for roofs, and 18,600 tarps have been installed by the Army Corps of Engineers.
- 22 municipalities are considered the hardest hit out of 78.
- Containers full of goods can be delivered directly to a location of RMF’s choosing.
On September 20, 2017, Category 4 Hurricane Maria hit the US territory of Puerto Rico. The winds, 155 miles per hour at landfall, completely wiped out the island’s power grid and phone towers. A flash flood emergency was declared in central Puerto Rico, and the island experienced record flooding.
Prior to the hurricane, Puerto Rico’s infrastructure was weak, and the storm left the small island crippled. Across the island, cities reported collapsed bridges and severe damage to roadways. On October 2, almost two weeks after the storm, 55% of people were still without access to drinking water, only 1 of 69 hospitals was fully operational, and 80% of the island’s crops had been destroyed. The full extent of the damage is still unclear, as most telephone and internet lines are still down. The damage has left many rural areas isolated, without access to communication or desperately needed supplies: food, water, shelter, and medical supplies.
- To provide primary health care and essential supplies to unreached, hurricane-affected communities
- To form local partnerships and empower local health professionals, ensuring effective service provision to communities most in need