Doctor Goes to Help Puerto Rico, Discovers the Disaster is Much Worse in Person

Doctor Goes to Help Puerto Rico, Discovers the Disaster is Much Worse in Person
Celine Thum, MD
November 17, 2017
I volunteered in Puerto Rico for two weeks, serving as a doctor in a mobile medical unit.
My team targeted rural communities in the middle, south and west coastal towns not yet surveyed by FEMA. We had expected that the state would have made progress a month after the storm, but outside of San Juan, conditions remained unchanged. Fences and power lines torn from the ground still obstructed the streets. Bridges collapsed and roads were impassable after landslides.
We walked through these neighborhoods asking locals if they needed a doctor or if anyone they knew was sick. Families sat outside to escape the heat inside their homes and the smell of mold and mildew from the flooding.
Children played outside and helped clean up the neighborhood. It was their 6th week without school, and there was no power for television. There were several run-offs at the bottom of the mountains where citizens would collect water for bathing, showering, cleaning, and drinking. Many were out of work and spent their days trying to clean up from after the storm, collect water, and wait for FEMA aid and assistance.
The patients I saw had not seen anyone other than neighbors and family since the storm. Their doctors had relocated to the States or had offices destroyed by the storm. Pharmacies were closed and they were running out of their medications and supplies. Without care, these patients will eventually succumb to infection, heart attacks, and strokes from uncontrolled hypertension, diabetes, COPD, asthma, and cancer.
The medical crisis of the people of Puerto Rico is multifactorial but largely stems from damages caused by the storm and lack of power and water. Critical medical interventions such as ventilators, dialysis, and refrigerated insulin are dependent on power. Without access to clean water, dehydration and heat stroke is prevalent, and the threat of a bacterial outbreak is eminent.
The citizens that live in isolated communities with impassable road hazards make it near impossible for them to travel to seek medical attention. For those who do, they find that local medical centers and pharmacies are closed due to damage, lack of power, and lack of running water.
Some invited us into their homes to tell us about their struggles — each house showed there was still a lot of work to be done, even a month after Maria. Physical aches and pains were common, as were anxiety and insomnia at night. Every day was a social and communal effort to keep tabs on neighbors and obtain food and water. Aside from the medical care provided, a visit from our team was therapeutic as they needed to tell their stories and their struggles acknowledged. I suspect some hoped I was a FEMA worker since to apply for aid required internet, telephone, or a visit to a disaster recovery center (the nearest could be more than 10 miles away). For a family living in the communities I visited, applying for aid was not feasible, and they continued to wait.
Their future was uncertain, and each day was another day they were waiting for aid, return of power, and return of water; even at week six before I left, however, there were no signs of infrastructure rebuilding in these rural communities.
During my two weeks in Puerto Rico, I had seen hundreds of patients, cured illnesses, provided drugs, and even saved a man who went into cardiac arrest. I have never treated a more grateful population in my life. There were those who insisted I drink bottles of water before them, in their own homes, as they were suffering from dehydration – simply because I was there to help their people.
I stood by the integrity of the medical care that I delivered, but felt a great deal of guilt upon returning home. It was difficult to leave people with so much need. While I may have bought some of these families time, the reality is that their survival depends on clean water, power, and food. They need their hospitals to reopen and pharmacies restocked. In three weeks, when the medications I provided run out, chances are they will once again be without their medications, power, and clean water.
While donations of supplies are certainly helpful, there needs to be more resources focused on restoring electricity and clean water lines. This means Americans from the mainland will need to work on the island for weeks at a time. I ask that friends and family support those who are working in Puerto Rico. It is certainly not easy or convenient, but the survival of the island depends on it. Consider donating to charities that are involved with hurricane relief. Charity Navigator rates charities on the percent donated that is spent on services provided and a good tool to use when trying to determine who to donate to.
If you are interested in volunteering, I recommend the following organizations: National Voluntary Organizations Active in DisasterRed CrossHabitat for Humanity, or consider joining a Disaster Medical Assistance Team.
About the Author: Celine Thum, M.D.  is an Emergency Medicine Physician, Medical Director of @ParaDocsEMS, Director of Emergency Ultrasound, and former @ABCHealthNews Contributor based in New York.
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