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Hurricane stresses Puerto Rico’s already weak health system

  • In this Thursday, Sept. 28, 2017 photo, Ramon Espinosa

  • In this Thursday, Sept. 28, 2017 photo, Dr. Victor Rivera attends Carmen Hernandez in a car in the hospital's parking lot for lack of space at the hospital in Bayamon, Puerto Rico. Hurricane Maria is stressing Puerto Rico’s already weak health care system. Rivera said they are so overwhelmed that he has been intercepting patients in the ER waiting room and even outside while people are still in their cars, to send them on their way with medical advice or a prescription in non-emergency cases. (AP Photo/Ramon Espinosa) Ramon Espinosa

  • In this Thursday, Sept. 28, 2017 photo, Damaris Torres watches over son Manuel Alejandro Olivencia at the hospital in Cataño, Puerto Rico. Days before the arrival of Hurricane Maria, Torres tried to find a safe place for her son, who has been bedridden for a decade after a traffic accident and depends on a ventilator, oxygen tank and feeding tube. “He’s in such delicate condition,” Torres said, her eyes welling with tears as she recounted how a hospital in the northern fishing town of Catano finally took him in. (AP Photo/Ramon Espinosa) Ramon Espinosa

  • Boatswain's Mate 3rd Class Taryn Armington and Sonar Technician (Surface) Seaman Darian Joseph prepare to cast off mooring lines for the Military Sealift Command hospital ship USNS Comfort (T-AH 20) as the ship departs Naval Station Norfolk to support hurricane relief efforts in Puerto Rico Friday, Sept. 29, 2017 in Norfolk, Va.. The Department of Defense is supporting the Federal Emergency Management Agency, the lead federal agency, in helping those affected by Hurricane Maria to minimize suffering and is one component of the overall whole-of-government response effort. (MC3 Brittany Tobin/U.S. Navy via AP) MC3 Brittany Tobin

  • Hospital employees sort donated canned food to deliver to a nearby shelter for hurricane victims, in Catano, Puerto Rico, Thursday, Sept. 28, 2017. The aftermath of the powerful storm has resulted in a near-total shutdown of the U.S. territory’s economy that could last for weeks and has many people running seriously low on cash and worrying that it will become even harder to survive on this storm-ravaged island. (AP Photo/Ramon Espinosa) Ramon Espinosa

  • The Military Sealift Command hospital ship USNS Comfort (T-AH 20) departs Naval Station Norfolk to support hurricane relief efforts in Puerto Rico, Friday, Sept. 29, 2017 in Norfolk, Va.. The Department of Defense is supporting the Federal Emergency Management Agency, the lead federal agency, in helping those affected by Hurricane Maria to minimize suffering and is one component of the overall whole-of-government response effort. (Bill Mesta/U.S. Navy via AP) Bill Mesta



Associated Press
Saturday, September 30, 2017

M artin Lopez was shot in the hand last Saturday by two thieves who made off with his precious cans of gas in the aftermath of Hurricane Maria. He was rushed to Centro Medico, a trauma center in the Puerto Rican capital where in ordinary times he would be quickly treated by surgeons and sent on his way.

But five days later, the 26-year-old cook was still waiting because only a fraction of the operating rooms were available due to an island-wide breakdown in the electrical power grid caused by the storm. He finally got the surgery and the hospital said he was on the mend Friday – but the same can’t be said for Puerto Rico’s badly stressed medical system.

“Thank God I’m fine, I’m getting better,” he told the Associated Press in an air-conditioned medical tent set up by the U.S. Department of Health and Human Services on the grounds of Centro Medico. “But Puerto Rico is destroyed. It’s really sad.”

Of all the problems unleashed by the storm, which roared over the island Sept. 20 as a Category 4 hurricane with winds up to 155 mph, the plight of overtaxed hospitals and smaller clinics – and health care in general – is one of the most worrying for officials grappling with recovery efforts.

The health system in the U.S. territory was already precarious, with a population that is generally sicker, older and poorer than that of the mainland, long waits and a severe shortage of specialists as a result of a decade-long economic recession. The island of 3.4 million people has higher rates of HIV, asthma, diabetes and some types of cancer, as well as tropical diseases such as the mosquito-borne Zika and dengue viruses.

In Maria’s wake, hospitals and their employees are wrestling with the same shortages of basic necessities as everyone else. There are people who are unable to keep insulin or other medicines refrigerated. The elderly are particularly vulnerable to the tropical heat as widespread power outages mean no air conditioning. And amid the widespread disruption, it’s often difficult to get kids to a doctor, especially for families who can’t afford to drive long distances on a tank running out of gasoline.

“Whenever there is a disaster that impacts an area to the degree that this one has, then yes, people’s lives are going to be in danger,” said Dr. James Lapkoff, an emergency room doctor in Waynesville, N. C., who was part of the HHS team dispatched to Puerto Rico.

Days before the hurricane hit, 56-year-old retired government worker Damaris Torres tried to find a safe place for her son, who has been bedridden for a decade after a traffic accident and depends on a ventilator, oxygen tank and feeding tube.

She has a small generator at home and a battery connected to an inverter as backup, but she didn’t want a rerun of what happened when Hurricane Irma hit just weeks earlier. Back then her son, 30-year-old Manuel Alejandro Olivencia, was transferred to three hospitals in less than 40 hours because his family was told there was no “special place” for someone on a ventilator.

“He’s in such delicate condition,” Torres said, her eyes welling with tears as she recounted how a hospital in the northern fishing town of Catano finally took him in.

That facility relies on a generator, but officials say they constantly worry about running out of fuel.

“Diesel is the one thing everyone is asking for,” Mayor Felix Delgado said as he visited the hospital on a recent morning.

Maria knocked out electricity to the entire island, and only a handful of Puerto Rico’s 63 hospitals had generators operating at full power. Even those started to falter amid a shortage of diesel to fuel them and a complete breakdown in the distribution network.

Patients were sent to Centro Medico and several other major facilities, quickly overwhelming them. The situation is starting to improve, with about half of the hospitals getting direct power or priority shipments of diesel, but that barely addresses the challenges facing the island as a whole.

Jorge Matta, CEO of the nonprofit that runs the complex of hospitals that make up Centro Medico, said progress was being made on restoring power capacity there and finding places to send patients whose homes were destroyed. He said they expected to have all 20 operating rooms at the trauma center back up this weekend. But other parts of the island are in much worse shape.

“Right now we have hospitals (elsewhere) that need diesel, they need water, they need oxygen,” Matta said.

Metro Pavia, which operates several hospital campuses across the island, warned Friday that it was closing emergency rooms in Arecibo and Ponce because it did not have enough diesel.

Meanwhile medicines are running low and obtaining fuel is an ongoing struggle, said Dr. David Lenihan, president of Ponce Health Sciences University, the only medical clinic currently serving southern Puerto Rico.

“If these things start deteriorating, there’s a significant amount of lives at risk,” he said. “We’re providing care, but it’s not optimal care.”

Gov. Ricardo Rossello has ordered that all major hospitals be placed on a priority list for receiving diesel.

The U.S. Navy has also dispatched the USNS Comfort, a hospital ship that has been deployed during previous disasters such as the 2010 Haiti earthquake.

The vessel’s sailing plan was a Friday departure from Norfolk, Virginia, with up to five days before it would reach Puerto Rico.