
Surviving Hurricane Maria
Nayeli Pagan still remembers the first harrowing hours after Hurricane Maria made landfall in 2017, the sound of the howling wind and her fear that she would run out of the diabetes medication she needed to stay alive.

Nine-year-old Nayeli never sleeps through the night. Neither does her mother. Sometimes Nayeli is awakened to get a shot – in her arm if she’s lucky, in her stomach if she’s not.
Nayeli has Type 1 diabetes. She was diagnosed when she was three years old and spent a month in intensive care as medical staff worked to normalize her blood sugar levels. But that normalization is an ongoing process. It’s a delicate but necessary balance to keep her alive.
In 2017, that balance – and Nayeli’s life – was threatened by Hurricane Maria. Nayeli’s family lives in Humacao in southeastern Puerto Rico, the side of the island where the catastrophic storm first made landfall.
Nayeli remembers those harrowing hours – the darkness, the howling wind, huddling inside a bathtub for protection along with her mother, father, sister and their dog, Roxie.
“It was so scary,” she recalls. “First the power went off and everything got dark. And then the wood that we put in the windows and on the back door just flew away. We ran to the bathroom because that was a place with no windows.”
Nayeli watched in terror as her father attempted to brace himself against the bathroom door that Maria battered again and again.
The hurricane finally subsided, and Nayeli’s family survived. But for Nayeli, the life-threatening aftermath lingered long after the storm passed.
With no power, Nayeli’s insulin could not be kept cold and would become useless.
That’s when Project HOPE stepped in.
As one of the first nonprofit organizations on the ground in Puerto Rico after Hurricane Maria, Project HOPE was able to bring Nayeli her precious lifesaving medication. Not only did our team help Nayeli in the critical short term, they also provided her insulin for a year, recognizing that Puerto Rico’s medical services would be seriously overburdened and desperately undersupplied.
Nayeli’s story is one of many such individual human dramas still unfolding in Puerto Rico that reflect the devastating impact of Hurricane Maria and the long term challenges that it is still posing to the island’s public health services as well as the need for targeted outside help.
During Project HOPE’s emergency response, volunteer health providers identified the substantial, long-term health needs of people with diabetes.

Diabetes is the third leading cause of death in Puerto Rico, after heart disease and cancer. The incidence and prevalence of diabetes continues to increase, particularly among adolescents. Preventing and managing diabetes can reduce health complications and dramatically reduce the number of deaths and disability caused by the disease. Project HOPE continues to provide diabetes education and medical services.
Although Nayeli’s wish is to be completely cured of diabetes, she is managing it well. One way she copes emotionally is by providing support to her stuffed monkey. “My monkey’s name is Coco and she has type 1 diabetes,” says Nayeli. “She has a banana for when her blood sugar is down. And then she has her insulin for when her sugar’s up.”
Nayeli helps Coco in the way that her family and Project HOPE has helped her.
“Project HOPE gave me my insulin after the hurricane and they also helped many others,” says Nayeli. “It’s so important to help people. Especially if someone has a condition or a medical problem like me. Someone needs to help them get their pills or their medicine or their insulin. Just like Project HOPE helped me.”

How you can help
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