The Current State of Recovery in Puerto Rico

The Current State of Recovery in Puerto Rico

January 29, 2018

While daily updates and headlines about Hurricane Maria’s impact on Puerto Rico have mostly faded, the ongoing challenges affecting recovery efforts must not be ignored. Perhaps the most recent challenge became evident with the governor’s decision to recount the death toll due to known issues in the ongoing documentation process, which was complicated by the island’s disrupted power grid and telecommunications difficulties.

Puerto Rico’s public health infrastructure is slowly coming back online, but progress is heavily dependent on other critical infrastructure elements such as power, water, fuel and road access, which were severely strained during the hurricanes. Without these essential resources, the island’s recovery has been hindered, and the bandwidth of its responders has been tested.

The damaged infrastructure, as it relates to power, is the most pressing constraint on the island’s ability to address public health needs. While most facilities are in contact with the Puerto Rico Department of Health and the healthcare supply chain to receive vital supplies, few are fully operational as many are still relying on generator power due to the unstable power grid on the island.

To date, roughly 30 percent of the island is still without power, and nearly half of permanent health centers are also without power or operating with generators. Frequent power outages and dependence on generator power leaves the island with minimal communication capabilities, complicating the task of providing healthcare services to those who need it most, such as patients on dialysis.

Of those still on the island, nearly 1,000 people are in shelters and unable to return home. NBC news recently reported more than 200,000 residents have evacuated to Florida alone. Evacuees are not expected to return any time soon due to the unstable healthcare system, loss of jobs and vital services such as clean water. These evacuations also indicate that economic recovery will be more challenging as well.

While many wonder when the island will be able to rebound from the massive impact of Maria and Irma, it’s still too soon to say. Before we can even begin to assess the timeline towards a full recovery, we first need to stabilize the island’s critical infrastructure. Power must be restored to the entire island, easy access to clean drinking water must be made available, and we must reestablish full operating status for hospitals and other care facilities across the island. Only once these boxes have been checked can we begin to think about the longer-term recovery and resilience needed to address future disasters.

Concurrent with simultaneous response and recovery efforts, Puerto Rico must also begin to prepare for the 2018 hurricane season, which is only six months away. This leaves little time for preparation – which will need to happen in tandem with current recovery operations from this year’s hurricanes. This is both a challenge and an opportunity – as we recover from Maria and prepare for what may come - we can “build back stronger” and create resilient infrastructure, including robust healthcare systems, stronger roads and an enhanced power grid.

While we think about preparing these critical systems, we must also consider the personal toll that Maria took on so many, remaining mindful that those affected will be dealing with the fallout and potential health impacts for years to come. From trauma, to acute and chronic concerns, there is a need for long-term, consistent efforts to help get residents back on their feet. This includes addressing the island's available mental and behavioral health services, which were experiencing significant shortfalls before the hurricanes hit.

Learning from the lessons of this hurricane season is crucial. But in so many ways, this hurricane season is not over for Puerto Rico. The reality is that Puerto Rico does not have the luxury of time, and we cannot sit back and slowly assess where we can improve. We must prioritize weaving recovery into the ongoing response efforts, while maintaining a mindset of rebuilding with a purpose. Investing in robust preparedness and resilience will ensure that critical systems, and residents, are better prepared to handle future hurricane seasons. So even if Puerto Rico begins to fade from the media, we cannot let it fade from investment conversations.

Nicolette Louissaint, Ph.D.

Dr. Nicolette A. Louissaint is the Executive Director of Healthcare Ready. Prior to this position, Nicolette served as the organization's Director of Programming. Before joining Healthcare Ready Nicolette served as a Foreign Affairs Officer at the U.S. Department of State in the Bureau of Economic and Business Affairs. During the height of the Ebola Epidemic of 2014, Nicolette served as the Senior Advisor to the State Department’s Special Coordinator for Ebola.