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.
WASH for Health
Two months after Hurricane Maria, many Puerto Ricans are still living without easy access to potable water and electricity. As Project HOPE medical volunteers continue to bring needed care to people living in still hard to reach locations, a newly implemented WASH program is helping to ensure long-term health for Puerto Ricans learning how to live in a changed environment after the massive storm.
A water, sanitation and hygiene (WASH) education team is now working alongside HOPE’s mobile medical unit team to help Puerto Ricans stay healthy by offering convenient education opportunities on treating drinking water, the importance of continuing to follow healthy hygiene habits, and preventing vector-borne diseases that are on the rise after Hurricane Maria.
“The incorporation of the WASH program into to the mobile medical units is ideal,” said Daniel Halpert, Project HOPE’s WASH expert in Puerto Rico. “People can seek medical care, visit our pharmacist for needed medicines but also learn how to make sure their water is safe to drink, learn the importance of continuing great hygiene habits, and reduce the risk of vector borne illnesses – all in one place.”
Halpert, who has coordinated WASH programs for the Peace Corps in Panama, said tailoring WASH programs to specific needs after disasters is very important.
“In Puerto Rico, most people already know the importance of accessing clean water and using preventative hygiene habits like handwashing, but because of the hurricane, they have lost all of their infrastructure, especially the access to clean water,” he explained. “All of a sudden, they can’t turn on the faucet and have potable water coming out of the tap.”
“Living with limited amounts of clean water is now forcing people to face unfamiliar decisions like, ‘Do I really need to use my scarce amount of water to wash my hands before cooking?’ But forgoing those important habits can lead to larger and devastating health issues.”
Without easy access to unlimited clean water, people are also dealing with other challenges, including proper water storage and how to use chlorination and purifying kits properly.
“Many people have been given water purification kits and chlorine tablets, but without experience using these treatments, many are not certain on what the proper usage is,” said Halpert. “Project HOPE is providing handouts that let people know how to properly purify a bucket of water, or even a milk jug of water, so that everyone can feel confident and safe in the water they are drinking and using.”
Flood damaged homes and piles of decaying vegetation after Hurricane Maria are also contributing to the increase of fly and rodent populations. “Rodents and flies have dramatically increased near and in people’s homes,” said Halpert. “Now anytime people put food out, it attracts rodents and flies that can greatly increase the risk of vector borne illnesses. Part of our WASH training is teaching people how to make home-made fly and rat traps with materials they have in their own home to help combat this problem.”
Hundreds of people have attended the WASH education workshops since they were added to the mobile medical units last week. “There is a real interest for this type of knowledge. People know they need help,” said Halpert. “Community members are very engaged in our trainings, and despite having already seen our medical staff and receiving their medications, they are eager to stay and listen to the hygiene promotion for 30 plus minutes, often lingering even after the training is over to ask follow-up questions and talk about their experiences since the storm. Many people also take flyers home to hand out to their neighbors.”
One participant, an older woman who is dealing with a fly and rodent issue for the first time in her life, was especially interested in learning how to make the homemade traps Halpert said.
Children are also getting in on the education.
“You have to start training young. If we can help kids adopt good hygiene habits, they carry these behaviors with them for the rest of their lives."
"We’re targeting a number of behaviors that all children must learn – handwashing, dental hygiene and trash management. Inviting parents to accompany their kids in these workshops is also great reinforcement for the adults.”
The Project HOPE team is working with volunteers and students from the University of Puerto Rico’s Graduate School of Public Health in Rio Piedras to grow the WASH education programs. In addition to the education courses being offered after each medical clinic, the WASH program is also providing participants with hygiene kits filled with soaps, towelettes, toothbrushes, and toothpaste, among other items. Project HOPE recently received a pallet of chlorine tablets through the Puerto Rico Department of Health, which will be distributed through the WASH program.
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Puerto Rico is starting to return to a sense of normalcy Hurricane Maria ravaged the island in late September. Electricity is slowing being restored throughout the island and schools have started reopening after being shuttered for over a month. Still, it’s a very different normal from what Puerto Ricans were accustomed to before the storm; a new normal that presents daily challenges to the health of many on the island.
Take Edgardo, a teacher in Ponce, a low-income community where resources are still scarce. He spends his days searching for clean water and gasoline, both of which are still in limited supply in many parts of the island. “Right now I worry about the health issues with the water,” he said, noting that he’s dealt with gastritis after the storm.
Getting food is still a challenge as well. Although most grocery stores are back in operation, challenges with distribution have driven up costs and made it more difficult to keep food fresh. “When I want to buy food on the supermarket there are a lot of empty shelves,” he said. “The produce in the stores are out of date in Ponce.”
Recently, Eduardo was able to visit Project HOPE’s Mobile Medical Unit to get treatment for his gastritis and hypertension. He was finally able to get medical care after weeks of struggling to find relief after the storm.
While he was able to find relief, he also has other people to worry about. His parents, who work as farmers, lost nearly everything in the storm. “Their house was completely ruined by the hurricane except for one room that is still standing,” he said. “They don’t want to leave their house because they have livestock.” His mother also faces challenges due to hypertension.
He also has concerns for his students, including those who are still at shelters because their houses were destroyed in the storm. The lack of clean water has contributed to conjunctivitis and scabies outbreaks, which are difficult to contain in the close quarters of a shelter.
Worries about his parents and students, on top of his own challenges, have made things stressful for Eduardo as well as many others struggling to cope with the new daily realities of life after Hurricane Maria. “I have a hard time sleeping,” he said.
Project HOPE is continuing to address the most pressing health needs in Puerto Rico. The team is using a mobile medical clinic model equipped with a stocked pharmacy and a multi-disciplinary team of doctors, nurse practitioners, nurses and pharmacists to provide care to hard-to-reach areas of the island like Ponce. The team was also recently joined by a mental health professional to support the growing need for mental health services among clinic patients.
Edgardo, like many on the island, is eager to see things return to the way things were before the storm. While it will still take time for that to happen, he sees how HOPE’s response is helping accelerate the recovery process. “This makes people feel secure and gives inspiration to move forward and to help,” he said.
Arlene has been suffering from migraine headaches for three years. After Hurricane Maria struck Puerto Rico in September, the stress of coping with no electricity, rationed clean water and limited access to health care caused by the storm only exacerbated Arlene’s condition.
When Project HOPE volunteers brought medical services to her community through a weekend clinic, Arlene’s discomfort was dramatically lightened. “After the Hurricane, I have felt so isolated and alone,” she said. “The Project HOPE team listened, and provided me with quality care, with such warmth.”
“Our medical volunteers are going community to community, reaching isolated and hard to reach areas that have still received little help since Hurricane Maria,” said Andrea Dunne-Sosa, HOPE’s Regional Director of the Americas and Volunteer Programming. “We were able to provide Arlene with a consultation, medicines and a referral letter for additional medical care. But almost as importantly, we were able to let Arlene know that we have not forgotten her and others like her who still need medical support after Hurricane Maria."
"Arlene was so relieved to see us and receive care, she expressed her gratitude through a tearful hug.”
Project HOPE’s Medical team continues to set up clinics in the communities most hard hit and difficult to reach in Puerto Rico, providing children, women and families with needed medical and psychological care and critical medicines, all while also helping to restore a sense of HOPE.
Since arriving in Puerto Rico after the storm, Project HOPE volunteers have
- Treated more than 1,500 patients
- Distributed 1,500 vials of insulin
- Coordinated the delivery of 2,600 water purification kits
- Transported $500,000 of medicines and hygiene kits to regions in most need
Volunteers are scheduled to continue working in Puerto Rico at least through December or as long as they are needed. Please support Project HOPE’s continuing work in Puerto Rico.
Mirldred lives in Penelas bo Rucio Sector La Hayce, a rural mountainous region in the municipality of Ponce in Puerto Rico. She lives there with her father, mother-in-law, husband and daughter.
Because of their remote location, Mirldred and her family have seen little help since the hurricane.
When the Project HOPE medical team arrived in Bo Rucio Penuelas in late October, it was the first medical care her family had received since the storm.
“I have been taking insulin for diabetes and medicine for my thyroid," Mirldred said. "Before the hurricane I only had one vile of insulin. I am supposed to use insulin three times per day at 50 units each dose, but now I am only able to use 50 units of insulin at night. I also use metformin twice per day. Without the right amount of insulin I feel tired and my blood sugar was 200-250.”
Like many, Mirldred’s family is still facing a long road to recovery. The hurricane ripped off part of the roof of her house - her family’s beds, clothes and documents have all been destroyed from continuing rains. Her water system was also ruined from the raging storm, forcing her to make difficult choices. “I started drinking both river water and filtered water because the municipality isn’t providing enough water for my family. I give the bottled water to my daughter and I drink the filtered water,” she said.
Her father has Alzheimer’s and his mental health is deteriorating even more since the hurricane. “I have a lot of stress now and I cry a lot and I don’t have time to rest. However, I consider myself somewhat fortunate, because some people lost their house entirely,” she said.
Mirldred is grateful for the health support provided by Project HOPE. Keeping her blood sugar level is one less worry. “There hasn’t been anybody to help us since the hurricane before Project HOPE arrived.”
“People should donate to Project HOPE,” she said. “We had been for weeks without medical care until Project HOPE reached our community. Donations are helping my people return to their normal life and providing primary health care to hard to reach communities like mine.”
Elsa Castro lost her home in the rural community of Punto Oro because of Hurricane Maria, but rebuilding after the storm was the least of her worries.
The storm cut her community off from aid in the days after the storm, making it difficult for her to get food and water. More importantly, it made it difficult for her and her family to get medical care.
“I worry about my sister who has cancer,” she said.
“This is my main concern since I am her main caregiver.”
Elsa also faces her own challenges. She’s 76, and suffers from has high blood pressure, high cholesterol and diabetes. Hurricane Maria made it more challenging for her to get the care and medicines she needs in order to keep her blood sugar and hypertension in check.
Her challenge is not uncommon in Puerto Rico. Many who live on the interior of the island have had limited access to medical care due to damaged roads, limited communication and other challenges caused by Hurricane Maria’s destruction. Project HOPE has responded to these challenges by setting up a mobile medical clinic in Puerto Rico, visiting hard-to-reach parts of the island that have not received care since the storm struck.
Recently the clinic, staffed with three nurse practitioners, two medical practitioners and a doctor, set up at a food and water distribution center near Elsa’s home. The team was able to provide Elsa with the care and medicines she needed to get her diabetes and heart issues back under control, so she could get back to focusing on her sister’s needs.
“I hope for a better world and that families can find sufficient food and water in the immediate future,” she said. “Project HOPE’s mobile clinic provided fantastic services!”
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