HOPE works in more than 35 countries worldwide. Please enjoy our blog as we document the successes and challenges of our work to provide Health Opportunities for People Everywhere.
Nayeli Pagan is one of the many children in Puerto Rico whose life has been changed in the wake of Hurricane Maria. She and her family live in Humacao, a small municipality on the southeastern side of the island where the storm first made landfall. When the storm hit, her family was forced to huddle inside a bathtub for protection after powerful winds blew off a door and other protection her family had put up to safeguard their home. “We felt insecure because it was the strongest wind we have seen on the island,” her father Omar said.
Still, in spite of all she’s lost, she has one simple wish.
“My dream is that I want diabetes to stay away so I can live a normal life.”
Nayeli was diagnosed with Type 1 diabetes at just 3 years old. She spent a month in intensive care as doctors and nurses worked to get her blood sugar back to normal levels. After she was released, the family faced new challenges in trying to keep her blood sugar levels normal.
“We tried to manage it with just a diet but it didn’t work. Her pancreas doesn’t produce enough insulin,” her father said. As a result, Nayeli had to learn at a young age how to monitor her blood sugar levels and self-administer insulin as needed. “The biggest challenge for me is measuring my insulin and putting it on the needle,” she said.
In order to help monitor her blood sugar levels, Nayeli wears a Continuous Blood Monitor (CBM) that relies on cell service to provide readings every five minutes that can be viewed on a cell phone. When her blood sugar is too low or too high it sends an alert to her parents so they can provide her with food or insulin to get her levels back to normal.
Unfortunately, Hurricane Maria’s destruction has created challenges with the system. “Due to the lack of telephone coverage on the island we haven’t had this system,” her father said. Many on the island still don’t have electricity or cell service a month after the storm, and it could still take several more months before service is fully restored.
In order to help better manage her diabetes, Project HOPE’s team in Puerto Rico provided Nayeli with a year’s supply of insulin. Her family knows the insulin will go a long way in making sure they can keep their daughter healthy, but also know on an island where nearly 15 percent of the population has diabetes, they’re far from alone in their struggle. “This has affected our life in so many ways - emotionally, economically, and our time as a family. There are a lot of people like us who need help,” her father said.
Aregelia Marvez still remembers the fear she felt when Hurricane Maria hit Marueño, a rural mountain village in the Ponce municipality of Puerto Rico.
“All the water was inside. It was really scary,” she said.
Since the storm, Aregelia has spent most of her time trying to clean and salvage what she can in her house, but it isn’t easy. “I have trouble getting back to normal. I have trouble sleeping and have a lot of stress.”
On top of the challenges and stress that come with rebuilding after a storm, Aregelia is also dealing with a number of medical concerns. She has diabetes, high blood pressure, and other heart issues. “Every day I’ve been depressed thinking how I’m going to get insulin and food.”
She had not received any medical care after the storm, until Project HOPE’s mobile medical team stepped in earlier this week. When the team reached Marueño, they were alerted to Aregelia’s issues and were able to bring her a month’s worth of insulin, donated by Eli Lilly and Company. It was the first insulin she had received in three weeks.
Elsy Benitez-Vargas, a Project HOPE volunteer nurse who focuses on diabetes management, was thankful they were able to reach Aregelia when they did. “I know if she hadn’t received this vial of insulin today she would have gotten very sick,” she said. “We avoided the need for hospitalization.”
It will still take a long time for Aregelia and the rest of the Puerto Rican community to recover from the devastating effects of Hurricane Maria, but HOPE's efforts have renewed her resolve. “I hope to recover everything that I have, the house, family," she said. "When you are down, you fight for life.”
Our medical team has seen firsthand the serious situation many still face four weeks after Hurricane Maria struck Puerto Rico. The biggest concern and need requested by the people is the need for basic supplies, including food, water, and medication, as well as supplies for personal hygiene and wound care. Without more intervention, folks may lose access to medications, vaccinations, and protection from mosquitoes which could carry Zika, Chikungunya, and Dengue Fever.
Leftover damage from the storm also continues to create problems. Homeowners have done what they can to clean up, but there is nowhere to dispose of large pieces of hurricane debris which is now rotting and creating new health hazards. Many also lost roofs as part of the storm and do not have the tools and equipment to repair them and give themselves protection from the sun during the day.
Additionally, over three-fourths of people on the island still do not have electricity, and many will not get it back for several more months. No electricity makes it difficult for people to store and cook food, and also makes it challenging to boil water.
Skin breakdown is also very common here. People would sit in their wheelchairs with no shoes. I would lift their heels up to see blisters and breakdown. We did lots of education on prevention of pressure sores. Many had medications but as time went on their medications ran out and they had no place to get refills. The following days we spent a lot of time holding clinics to refill medications.
During our outreach in Loiza, we met a nun who knew the people and the area well, and sent us to a few homes where elderly and homebound patients lived. She had not seen them since the hurricane and was concerned about them.
One man was 98 years old and very emaciated, with sores and bruises all along his spine. It turned out he was sleeping on the floor and the hardness was causing skin breakdown on his bony spine.
The next day, one of our doctors returned to his home and brought him an egg crate mattress from our shelter where we were staying. He said it was an extra one that no one was using. You could see his gratitude but I could also tell he was a bit embarrassed. I just gave him a big hug and wanted to take him home with me.
There was another man who lived by himself and was wheelchair bound. He was barefoot and legs were swollen. We treated some wounds on his feet and wrapped his legs to decrease the swelling.
We asked him if he had water and he replied that he did. I asked him if I could get it for him. He had three small bottles in the refrigerator. His refrigerator door was open and the food there was moldy and dangerous to eat. He knew not to eat any of it but was not able to clean it out. There were flies and mosquitos everywhere. He said the three bottles would be enough but we knew otherwise. He said there were people much worse off then he was. We left him with water and canned food for several days.
His response was a common one we heard from many we helped during our time there. The people are so humble and did not complain about their situation. They simply expressed concern about their neighbors and family even though they had nothing themselves.
Sheila Grisard, a long-time volunteer nurse for Project HOPE was busy organizing donated supplies at the University Pediatric Hospital on Sunday. Working with two other HOPE volunteer nurses, and some volunteer students at the hospital, the group had nearly completed unpacking and organizing the donations when a pediatric doctor frantically ran into the supply room, requesting a size four tracheostomy for an infant who needed it immediately.
"Unfortunately we had not come across any tracheostomies in all our unpacking,” Sheila said. The pediatrician immediately returned to the infant, but Sheila and the team were determined to find a tracheostomy to save the infant. I reached over and pulled several boxes of rubber gloves off the shelves and was so excited to find a box of tracheostomies. I called for two students to help me find the size and the rest of this story is a miracle," she continued.
"At the bottom of the box was the size four tracheostomy that the doctor needed to save the child’s life. I grabbed it and ran up the stairs hoping we weren't too late."
"I can't tell you how excited everyone was to see that one size four tracheostomy in that entire room of donated supplies! What an amazing miracle and gift.”
Three weeks after Hurricane Maria ravaged Puerto Rico, the situation on the island remains dire – particularly for those in need of health care.
Federal officials have reported that less than half of the island’s medical work force has returned to work since the hurricane as many are struggling to recover themselves.
Those that were sick before are struggling to get the care and medications they need.
Project HOPE volunteers continue to fill the gap, whether finding the right tool just in time to save a young life, or bringing care and medicines to people living in hard-to-reach areas of the island that are still in critical need.
Thanks to your support, medical volunteers are providing support to local health facilities as well as establishing and staffing mobile medical clinics in high-need communities, visiting local nursing homes and conducting home visits to reach patients unable to make it to the clinics.
In the past few weeks:
- Volunteers have treated more than 320 patients in the hard-hit town of Loiza, in addition to refilling prescriptions and medication needs for community members.
- Project HOPE, working with partners on the ground, is distributing medicines and relief to hard-to-reach areas of the island that are still in high need of supplies.
- Through the support of two generous donors, Project HOPE is coordinating the delivery of 2,600 water purification kits to a local partner. Each kit can purify up to 3,000 liters of water, which is enough for a family of four up to one year. This donation could provide clean water to more than 10,000 people for a year.
- Project HOPE has implemented a Special Flights Initiative supporting the direct transport of HOPE medical volunteers, identified medicines and supplies from the U.S. to Puerto Rico via private aircrafts.
Today, my husband, Dr. Neil Shocket, and myself are completing our volunteer assignment with Project HOPE in Puerto Rico. It feels sad because I know there is so much more to be done, but I'd be lying if I didn't admit that a nice shower and a soft bed to sleep on is sounding pretty good at this point (and no mosquitoes)!
We held a community clinic at a local church in a Loiza today, a town HOPE has been working in since Hurricane Maria hit because of the need and the lack of access to health care residents now have because of the storm.
We had an incredible turnout, it felt like we saw the entire community.
Most of our patients were diabetics needing medicines, people with hypertension, a few colds and flu.
The benefit to the community is measurable and the people are so grateful.
We also made our daily Walmart stop this morning and bought tons of personal hygiene supplies to give away. The sad thing is there has been no water to be found for the last three days!
On the U.S. assistance front, we have seen a few planes fly along the shoreline. I am sure there is help on the ground but none of us has seen it.
As Neil and I, and several other Project HOPE volunteers return home, a new team of RNs, nurse practitioners and doctors will continue providing health services and hygiene awareness in the hard-hit municipality of Loiza and delivering supplies and medicines to those who still need help.
Thank you to Project HOPE and the lifesaving work they do and thank you for letting Neil and I be a part of providing health care and support to so many in need after Hurricane Maria.
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