How Hurricane Maria will damage Puerto Rico’s health care for many months to come

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.

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