Maria’s Cloudy Death Toll in Puerto Rico

Maria’s Cloudy Death Toll in Puerto Rico

November 10, 2017

Nearly two weeks after Hurricane Maria made landfall in Puerto Rico, local authorities estimated the associated death toll at only 16 fatalities. But after further investigations, that official death count more than tripled to 51. And now, a full month after Maria’s landfall, investigative journalists and local authorities have discovered that over 900 deaths may be attributable to Maria – potentially 18 times the most recent official death toll.

But why might the original death count be so underestimated?

It’s likely that impaired infrastructure and communications prevented civilian deaths from being properly categorized and recorded. Although local authorities have stated that “natural causes” are the catch-all explanation for these 900+ deaths, many challenges create uncertainty in whether Maria’s sustained and far-reaching impacts were directly or indirectly associated. With communication services in remote areas still severely impaired, and three-fourths of the island still without power, causes of death may easily slip off the record, and many deaths may be outright unreported or unknown of (i.e., there are still dozens of missing civilians across the island).

In Puerto Rico’s post-disaster conditions, it may be a long-shot to pinpoint the specific causes of the over 900 deaths, and the focus should be on preventing further fatalities. Healthcare Ready’s priority remains engaging with public and private organizations on public health preparedness and response efforts. For example:

  • We are coordinating with civic groups to reach deeper into suburban and rural communities that remain isolated and under-resourced due to sustained barriers;
  • We are connecting health facilities, clinics and pharmacies to Puerto Rico’s Department of Health in order to synchronize and centralize public health needs and relief efforts; and
  • We are collaborating with telecommunications organizations, such as Sprint and the National Health IT Collaborative for the Underserved, to improve communications capabilities across the island by distributing satellite phones and radios to emergency responders.

But we can’t ignore an important question that Maria’s highly ambiguous death toll raises for future hurricanes and disasters: which deaths could have been prevented had Hurricane Maria not hit Puerto Rico? The answer to this question would help us better understand the gaps in emergency response and where relief efforts might be most effective.

While we are still learning Puerto Rico’s full death toll, if this most recent record-breaking hurricane season has taught us anything, it’s that the initial impact of a hurricane is just the prelude. The long-term and sustained impacts of Maria are still in full-force, and Healthcare Ready continues to focus its efforts on preventing Puerto Rico’s death toll from rising further.

Nicolette Louissaint, Ph.D.

Dr. Nicolette A. Louissaint serves as 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. Nicolette earned a Ph.D. in Pharmacology and Molecular Sciences, specializing in HIV Clinical Pharmacology from Johns Hopkins University School of Medicine. She completed post-doctoral fellowships at the Johns Hopkins University and the American Association for the Advancement of Science.