Untreated Chronic Disease and Stress Prevalent in Shelters Housing Victims of Hurricane Maria

Zika, Chikungunya and Dengue Fever Looming

Before going to sleep last night we listened to the Mayor of Puerto Rico give her plea for help for the people of Puerto Rico. It was amazing to be listening to her from here, versus my comfy bed at home. It felt pretty cool to know we were here trying to answer her plea. A nice feeling.

Three more nurses and another physician joined our team. It’s fascinating to see the work that goes into this effort from a simply logistical perspective. The Project HOPE team is incredible and they take so much care in ensuring their volunteers are safe and taken care of.

Today we returned to Loiza to set up a clinic. We are bringing food and hygiene packages that we prepared yesterday. The need goes far beyond medical and we are trying to meet as many needs as possible. Our container of supplies has arrived at port so we are hoping to improve our inventory of medical supplies in the next few days.

Our clinic was set up at one of the two shelters in Loiza. The shelter is at an elementary school.  Different sections are designated for shelter residents with separate areas for those who are bedridden. We set up our clinic in a classroom. We designated areas for three providers to see patients, an area for wound care, our pharmacy and another area for our personal hygiene giveaways. Most of the people there have been at the shelter since the hurricane hit the island nearly two weeks ago.

There is no running water, electricity or air conditioning. You flush the toilet by filling a bucket from a rain barrel and pouring it fast down the toilet.

One of my patients today was a diabetic amputee. She was evacuated from her house in her wheelchair with the clothes she had on her back and has not returned since. Her chief complaint was that she was feeling stressed. She explained that she had bills to pay, laundry to put away and 22 cats that she was deeply concerned about. I asked her for her address and she gave detailed directions to her house. We told her that our team will go there tomorrow morning on the way to clinic. We have no idea what the condition of her house will be or if it will be there at all.

We will stop at Walmart and pick up cat food before we leave, just in case we can find the cats. She gave us specific directions where to find her clothes and specifically where to find her perfume. She said this is a very important item because she had not showered since the hurricane!

We also started a diabetic clinic were we evaluated the needs of the many diabetic patients. Most are on insulin and are concerned about refrigeration of their medication and refilling their prescriptions. Most of the diabetic patients were in the general shelter area – each of them made quaint little living areas for their cots and their minimal belongings. I noticed that one area made use of a mosquito net and I came to realize that mosquito nets were donated to everyone at the shelter but most were not being used.  So my husband, Neil, who is also a volunteer physician for HOPE in Puerto Rico, and I talked to each of the families and explained the importance of using their mosquito nets.  Most of the families were resistant because it is so hot and uncomfortable, they feel the mosquito nets are making them feel claustrophobic and unable to breathe.

Unfortunately, in this area Zika, Chikungunya, and Dengue fever are prevalent.

One can easily see that the future does not look good for this community. The potential for failing health care and growing poverty is obvious. There is no employment and people are struggling to get along with the donations they are given. When the attention is off of Puerto Rico, I fear for what will happen to these people.

Despite the conditions, the Puerto Rican community is strong, friendly, welcoming and most importantly exceptionally grateful for the help they are getting.

I still have not seen any federal officials on the streets in San Juan or in Loiza. I am hoping they are here but just not in our view.

Tomorrow we will make our routine visit to Walmart to pick up some gift items for those at the shelter that who are immobile. Some of the requests we have are for Sensodyne toothpaste, sausage and a foam bed pad. Such simple items, but for them they mean a world of difference.

Tomorrow we will return to Loiza and begin our community visits. Part of the team will work in the clinic and the rest of us will walk the streets and make home visits to people who cannot get to the clinic. I am looking forward to that because I love seeing the families, children, their pets and the community.

This continues to be an extraordinary mission for Neil and I. We are deeply moved by the efforts made by everyone at Project HOPE and all of the incredible passionate, caring volunteers. We are so grateful to have been given the opportunity to participate as the first team.

We are still staying at the Jewish Community Center, and grateful for the accommodations. This is a conservative synagogue so we have to be up and out early before their 7:00 morning services. It is nice to hear the praying in the background. It kind of adds a spiritual component that a few of us connect to. Many of the congregants have been affected and we are trying to help them out as well with food and medicine.