In the wake of Hurricane Maria, the strongest storm to hit the island in 80 years, the American Commonwealth of Puerto Rico is left with an increasingly dangerous health crisis. The tragic situation on the island is unfortunately not that surprising, given its known physical, social, and economic vulnerability to extreme weather events. Before Hurricane Maria, 46 percent of the population fell below the poverty line, almost half of the population depended on Medicaid, and 92 percent of municipalities were deemed underserved by the U.S. Health Resources and Services Administration. Now, Puerto Rico is scrambling to get its chronically underfunded healthcare infrastructure back online.
The biggest obstacle on the island is the devastated electricity grid. With only 16 percent of the island's power restored, providing adequate medical care to roughly 3.4 million residents has been difficult. Hundreds of residents have had to be transported off-island for treatment. The death count is at least 48, and it's expected that many more citizens will die of "preventable deaths" due to fuel shortages, scarce medicinal resources, logistical obstacles, water contamination, and the looming threat of infectious disease. Three weeks after the storm, most hospitals are still barely hanging on with temporary diesel generators and unpredictable fuel deliveries. The President temporarily waived the Jones Act—although the waiver has since lapsed—and the House approved a $36.5-billion aid disaster relief package that includes money for Puerto Rico. However, quick fixes and temporary actions aren't going to protect our most vulnerable populations in the long run. It’s time to seriously look at how to increase the safety and resilience of not only the healthcare sector, but of Puerto Rico as a whole before another disaster strikes.
Hurricanes and other extreme weather will only get more deadly and destructive as carbon pollution warms the climate. According to the U.S. Environmental Protection Agency, the ocean surrounding Puerto Rico has already experienced a temperature increase of 2 degrees Fahrenheit since 1901, and sea levels are rising by about one inch every 15 years. Our current administration isn't doing Puerto Ricans any favors by denying the role of humans in climate change or—worse yet—by rolling back federal limits on climate-warming pollution.
We know that preparing for climate change can help reduce the destruction and recovery time associated with natural disasters. When Hurricane Sandy struck the northeast in 2012, hospitals and care centers had thankfully taken precautions after witnessing the crippling of New Orleans' health care system during Hurricane Katrina 7 years before. Emergency generators were moved to higher floors or encased in concrete to stand up to unprecedented storm surges, detailed emergency plans were in place, and patients were successfully evacuated when necessary. Additional out-of-state resources, like ambulances, search and rescue teams, and medical professionals were brought in by the Federal Emergency Management Agency and the Department of Health and Human Services after the storm.
This kind of preparation and planning is neither cheap nor easy. For one thing, Puerto Rico and the U.S. Virgin Islands need emergency plans tailored specifically to them; a disaster relief plan for New York City wouldn’t be applicable to the islands due to geographical, economical, and cultural differences. As Aris Mejías, an actress and activist from Puerto Rico, put it: “They don’t take into account that we’re an island. They don’t take into account our infrastructure. They don’t take into account humidity…. They don’t take into account geography—and in our particular case, that we’re a colony.” Legislation like the Climate Change Health Protection and Promotion Act would provide critical technical support to public health officials as they prepare for weather disasters and other health crises associated with climate change.
We owe it to the people of Puerto Rico and the U.S. Virgin Islands to treat their current recovery needs with the urgency they deserve. At the same time, we must act to minimize the impact of future disasters by strengthening the healthcare system, planning for the unavoidable effects of climate change, and cutting climate-changing pollution by transitioning to a cleaner energy future.