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Hurricane Maria and Puerto Rico

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  1. Health care in Puerto Rico after Maria
    Puerto Rico’s Health Care Is in Dire Condition, Three Weeks After Maria By FRANCES ROBLESOCT. 10, 2017 Continue reading the main story Share This Page Photo Medical associations and private relief agencies have been conducting missions throughout Puerto Rico to bring medical care to areas in need. In Caguas, some patients received care in a hospital tent. Credit Dennis M. Rivera Pichardo for The New York Times CAGUAS, P.R. — Harry Figueroa, a teacher who went a week without the oxygen that helped him breathe, died here last week at 58. His body went unrefrigerated for so long that the funeral director could not embalm his badly decomposed corpse. Miguel Bastardo Beroa’s kidneys are failing. His physicians at the intensive care unit at Doctors Hospital in Carolina are treating him for a bacterial disease that he probably caught in floodwaters contaminated with animal urine. José L. Cruz wakes up in the middle of the night three times a week to secure a spot in line for dialysis. His treatment hours have been cut back to save fuel for the generators that power the center. “Because of the electricity situation, a lot of people died, and are still dying,” said Mr. Figueroa’s daughter, Lisandra, 30. “You can’t get sick now.” Continue reading the main story Related Coverage Minus Electrical Grid, Puerto Rico Becomes Generator Island OCT. 7, 2017 84 Percent of Puerto Rico Still Doesn’t Have Power OCT. 10, 2017 Higher Puerto Rico Death Toll Reflects Survey Across Island OCT. 4, 2017 Photo Yarelis Rosa visited her husband, Miguel Bastardo Beroa, at a hospital in Carolina, Puerto Rico. Doctors suspect that he contracted leptospirosis in contaminated floodwaters. Credit Dennis M. Rivera Pichardo for The New York Times Nearly three weeks after Hurricane Maria tore through Puerto Rico, many sick people across the island remain in mortal peril. The government’s announcements each morning about the recovery effort are often upbeat, but beyond them are hidden emergencies. Seriously ill dialysis patients across Puerto Rico have seen their treatment hours reduced by 25 percent because the centers still lack a steady supply of diesel to run their generators. Less than half of Puerto Rico’s medical employees have reported to work in the weeks since the storm, federal health officials said. Continue reading the main story ADVERTISEMENT Continue reading the main story Hospitals are running low on medicine and high on patients, as they take in the infirm from medical centers where generators failed. A hospital in Humacao had to evacuate 29 patients last Wednesday — including seven in the intensive care unit and a few on the operating table — to an American military medical ship off the coast of Puerto Rico when a generator broke down. There are urgent attempts to help. The federal government has sent 10 Disaster Medical Assistance Teams of civilian doctors, nurses, paramedics and others to the island. Four mobile hospitals have been set up in hospital parking lots, and the Comfort, a medical treatment ship, is on the scene. A 44-bed hospital will soon open in badly wrecked Humacao, in the southeast. But even as the Army Corps of Engineers is installing dozens of generators at medical facilities, and utility crews work to restore power to 36 hospitals, medical workers and patients say that an intense medical crisis persists and that communications and electrical difficulties have obscured the true number of fatalities directly related to the hurricane. The official count rose on Tuesday to 43. Matching resources with needs remains a problem. The Puerto Rico Department of Health has sent just 82 patients to the Comfort over the past six days, even though the ship can serve 250. The Comfort’s 800 medical personnel were treating just seven patients on Monday. Continue reading the main story From Our Advertisers Photo Villa Hugo in Canovanas remained flooded for days after Hurricane Maria swept across the island. Reports of diseases related to water contamination have been rising. Credit Dennis M. Rivera Pichardo for The New York Times The mayor of Canóvanas, in the northeast part of the island, reported over the weekend that several people in her city had died of leptospirosis, the bacterial disease Mr. Bastardo is believed to have caught from the floodwaters. The Puerto Rico Department of Health said Sunday night that several cases were being evaluated, but that lab tests had not yet come back to confirm the diagnosis. At the same time, the agency urged people to drink only bottled water and to wear protective shoes near bodies of water that could be contaminated with animal urine. Carmen C. Deseda, the Puerto Rico state epidemiologist, said that six people were being treated for leptospirosis, even though test results to confirm the diagnosis would not be complete for another week or two. Puerto Rico usually sees a few dozen cases a year and perhaps one death, but officials are expecting an increase because of the flooding. Forty percent of the island still lacks running water because of the blackout, which still affects 85 percent of the island. As a result, many people are bathing in streams and receiving nonpotable water from huge tanks. Yarelis Rosa, 37, said her husband, Mr. Bastardo, was infected because he had cut his hand a few days before the storm and it had not fully healed when he spent hours in the floodwaters trying to escape his home in Canovanas. A few days later, Mr. Bastardo’s head, feet and knees hurt and his temperature soared to 106 degrees. She took him to the hospital more than a dozen times, she said. “I.V., injection, go home. I.V., injection, go home. I.V., injection, go home,” Ms. Rosa said, describing the revolving door of medical treatment. Continue reading the main story Recent Comments Patriot in BH 9 hours ago It is beyond frustrating that weeks after the Hurricane hit Puerto Rico, there still are not enough HELICOPTERS on the island to save lives... John 9 hours ago Sorry Puerto Rico you've had your 15 minutes of fame, the Donald has more important things to do. Be patriotic and Shut Up. Jeff 9 hours ago Where is the aid from the Trump Administration? The World wonders while Puerto Rico suffers. See All Comments Write a comment Photo Shelves of medicines at the field hospital in Caguas, P.R., on Saturday. Many medical facilities on the island are short of necessary supplies. Credit Dennis M. Rivera Pichardo for The New York Times He was intubated on Friday, she said, the same day that the patient next to him died of the same illness. “Nervous? It looked like a war zone, where you have to evacuate to save your life,” she said, describing the scrambling doctors. “The politicians say that everything is fine, because they have nice places to live. Why didn’t they bring Donald Trump here?” In Caguas, a city of 142,000 south of San Juan, the municipal 911 manager, José Oramas, said that city ambulances had responded to at least four calls since the storm where a patient who had lost power for oxygen tanks or ventilators had died. At Hima Hospital in Caguas, doctors deployed by the federal government are treating patients under an air-conditioned tent in the parking lot. But a health professional from another team, who was not authorized to speak publicly, said many of the teams were not seeing patients and felt powerless to help with the main need, which is a stable power supply. “It’s very critical,” said Maria Jacobo, the administrator of Hima Hospital. “The whole island is critical, especially for oxygen.” At the mobile hospital on Sunday, Luz Alverio was with her 72-year-old sister, Irma, whose legs are swollen and discolored from infected insect bites. “People didn’t die in the winds,” Luz Alverio said. “They are dying now.” Continue reading the main story Photo Doctors examined festering insect bites on Irma Alverio’s legs in a hospital tent in Caguas on Saturday as her sister, Luz Alverio, looked on. Credit Dennis M. Rivera Pichardo for The New York Times The situation is particularly serious for Puerto Rico’s 6,000 dialysis patients. On its hurricane update website, the Puerto Rican government says that all 46 dialysis centers on the island have received assistance, and the Department of Defense counts 43 centers as operational. The website does not mention that the diesel fuel shortage is still so severe that many patients whose blood is normally cleaned for 12 hours a week are now being treated for only nine. “At one point, the government said the dialysis situation was controlled and the facilities were getting diesel,” said Lisandro Montalvo, the medical director of Fresenius Medical Care North America, a chain of dialysis centers here. “But they maybe supplied diesel to three or four facilities, and we have 26 facilities. We talk to FEMA every day. It’s always an emergency. We have to say: ‘These three are low, please.’ Sometimes they fill it, and sometimes they don’t.” Mr. Cruz receives his dialysis treatment at a different chain of centers. He said that in the days after the storm, all the centers were closed, so patients were swarming to hospitals, where they were getting just half the prescribed treatment. Witnessing a woman’s death during dialysis helped persuade him that he should leave Puerto Rico, rather than keep having to struggle to find a spot in line. He plans to move to Orlando, Fla., on Wednesday. “They are cutting my life short,” Mr. Cruz said. “The governor can’t be everywhere at once. If his aides tell him everything is great, he thinks everything is great.’’ Ricardo Rosselló, the governor of Puerto Rico, said on Monday that the authorities were doing their best to stave off a public health disaster. About 70 percent of the island’s pharmacies had reopened, he said, and a special hotline had been established for people to receive insulin. He added that dialysis centers were “in the loop” for fuel and generator repairs and maintenance, and several patients had been evacuated to the mainland United States. Get the Morning Briefing by Email What you need to know to start your day, delivered to your inbox Monday through Friday. See Sample Privacy Policy Opt out or contact us anytime Lt. Gen. Jeffrey Buchanan, who leads the military effort on the island, said that several hospitals had suffered structural damage in the storm, and that even those that are officially listed as open face serious limitations. “Define ‘open,’” General Buchanan said. “The fact that they are providing treatment is one thing. Are they taking new patients? I won’t feel comfortable until the hospitals are back on the grid and they have sufficient medicines across the board.” Ricardo Ramos, chief executive of the Puerto Rico Electric Power Authority, the island’s utility, said that restoring power to hospitals was the company’s No. 1 priority. Mr. Ramos said the utility had worked hard to make sure that there was at least one hospital able to treat patients in each region of the country, and that it had restored power to one of the island’s two facilities for producing medical oxygen. “I would love to have all the hospitals energized, but it’s impossible to do that,” he said. “There are hospitals in the mountainside, there’s hospitals in the southeast, where my infrastructure is completely destroyed.” Robert P. Kadlec, the assistant secretary of Health and Human Services for preparedness and response, said the Veterans Health Administration had also opened its hospitals to nonveterans to help meet urgent needs. “The devastation I saw, I thought was equivalent to a nuclear detonation,” Dr. Kadlec said. “Whatever you do, will be almost insufficient to the demand and need that is out there for these 3.5 million Americans in Puerto Rico. We are doing everything we can with what we have, and we have a lot.’’ Correction: October 10, 2017 A picture caption with an earlier version of this article misstated the location of the hospital where Miguel Bastardo Beroa was being treated. It is in Carolina, P.R., not Canovanas. You can edit text on your website by double clicking on a text box on your website. Alternatively, when you select a text box a settings menu will appear.