“It looked like a bomb went off.”

Such is the world that Patti Fisher, MD, found when she and a group of 7 others disembarked from a boat that took them from Ft. Lauderdale to the island of Puerto Rico in the aftermath of Hurricane Maria. There to provide medical relief, they found an island whose entire infrastructure was decimated by the roaring winds and rising waters of the monster storm.

Puerto Rico: A Country in the Wake of Devastation

Across the island, power lines and telephone poles were down. Roads and bridges that hadn’t been washed out were spotted with cars, some moving, some completely stopped. Lines at gas stations snaked through what used to be neighborhoods, with drivers waiting up to 11 hours for a tank of gas. In a precarious new world where only cash was accepted, long lines formed at every functioning ATM.

The hospitals were all running on generators, lifesaving technology sustained by dwindling fuel. Patty arrived five days after Maria struck, and she found that one of the hospitals had just six hours of diesel left.

Around the island, people sat in their battered homes, unsure of where to go or what to do.

The systems built to protect people were fractured or non-existent. There’s no 911 to call. FEMA and other organizations that were there to help were not communicating with each other.

The mood of the people varies. Initially, many were just happy to be alive. That changes as the weeks drag on without power and no end in sight. Moods are fraying.

Missed Opportunities and Time Lost

The logistics of providing help were equally frustrating for those who came to help. Patti and her team acted as a sort of mobile unit, traveling from village to village, to see where they could be the most useful. Without much support and with little communication, this meant a lot of driving, missed opportunities, and time lost.

Patti spent most of her time helping people get their medications refilled. Without functioning pharmacies, it was difficult getting people their high blood pressure and diabetes medications at a cost they could afford. “One woman was charged $280 for medications that she could have gotten in generic form,” says Patti. “People became distraught and anxious. And these were not medications they could do without.” 

It was these scenarios, played out time and again, that proved to be the biggest surprise for Patti and her team. “The logistics of everything were just so difficult. The medical needs in and of themselves were less obvious. The health care infrastructure was broken, and the ripple effect was all-encompassing.”

“The Makings of a Public Health Crisis”

It doesn’t appear that things will improve anytime soon. “Without power or water, I think things will get worse.  There will be more problems with diarrhea, skin problems and other worrisome health issues. You have the makings of a public health crisis here.”

Against the backdrop of the confusion and uncertainty are the people themselves. “They are bewildered by what’s happened,” she says. “They are frustrated and upset that the systems aren’t working. Yet they are grateful for the help that comes their way. We felt like a lifeline.”

Patti Fisher, MD, travelled to Puerto Rico with a team sponsored by Heart to Heart, an international organization that is providing medical relief to some of the hardest-hit and remote areas of Puerto Rico. To learn more, visit Hearttoheart.org

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