Puerto Rico’s Battered Hospitals On Verge Of Failure

A week after then-category 4 Hurricane Maria made landfall in densely populated eastern Puerto Rico, electricity remains offline across most of the island, while supplies of staples like gas, food and water are dwindling. Shelters on the island are reportedly running low on food, and the government managers of the emergency response effort are scrambling to evacuate 70,000 people from a river valley that’s in danger of being completely submerged after a nearby dam failed.

And now, Reuters is reporting that hospitals across the island are struggling to continue providing medical services to patients after the storm left many of them flooded, strewn with rubble or relying on diesel-powered generators that will soon run out of fuel. For some, the only option is to evacuate to the United States for treatment.

Among these patients is a baby with a heart defect who had the misfortune of being born just before Maria hit.

“Among them is Cheira Ruiz and her baby girl Gabriellyz, who was born two weeks ago with a serious heart defect. The newborn was admitted to the Centro Cardiovascular de Puerto Rico in the capital shortly before Maria slammed into the island last Wednesday, but it was impossible for doctors to operate in such precarious conditions.”

Gabriellyz was among the first infants cleared to take a medical flight out of Puerto Rico since the storm. Her parents, who live two hours south of the capital, found out the good news Friday when emergency officials knocked on their door in the town of Guanica and told them to pack for the trip to Miami. With phone service out, the doctors had called one of the island’s radio stations, which broadcast their plea for help in locating the couple.

Hours before the flight was scheduled to depart, the parents learned there was only room for one of them. Mother and baby would fly alone to Miami.

“I’m trying to be strong,” Ruiz said on Saturday.”

Across the island, the scene is nightmarish as motorists and pedestrians line up for blocks waiting to purchase scare resources like fuel to power the generators. Cellular service, internet, and email have vanished, and radio has become a primary source of information. In what sounds like a plot detail from the Mad Max movies, fuel is in such short supply on the island that deliveries to hospitals are made by armed guards to fend off looters. Hospitals trying to transfer critical patients are being turned down by other facilities, simply because there is no room, or they can’t afford to purchase fuel.

For hospitals across this region, the challenges are mounting. After the power went out, back-up generators at some hospitals failed quickly. Other hospitals are running critically low on diesel. Fuel is so precious that deliveries are made by armed guards to prevent looting, according to Dr. Ivan Gonzalez Cancel, a cardiovascular surgeon and director of the heart transplant program at Centro Cardiovascular.

“Another hospital wants to transfer two critical patients here because they don’t have electricity,” Gonzalez Cancel said. “We can’t take them. We have the same problem.”

Another problem is that nurses and doctors are running low on gasoline for their daily commutes to work. Puerto Ricans are waiting as long as seven hours at the island’s few functioning filling stations. Marilyn Rivera Morales, a nurse at a hospital cardiovascular center run by Dr. Ivan Gonzalez Cancel who spoke with Reuters, said she had enough gas left to drive to the hospital for two more days.

“How will they keep coming here if they don’t have gas?” Gonzalez Cancel wondered.

Gonzalez’s cardiovascular center was “in shambles,” he told Reuters Running without air conditioning, the walls of the operating room were dripping with condensation and floors were slippery. Most patients had been discharged or evacuated to other facilities, but some patients remained because their families could not be reached by phone. On the sidewalk outside the cardiac center on Saturday, Jorge Rivera and his wife Dorca approached Gonzalez Cancel to ask about the woman’s father, a patient still inside waiting for triple-bypass surgery. The couple are residents of Savannah, Georgia who were in Puerto Rico to care for their loved one.

The Doctor responded with what we imagine was unwelcome news: They’d have better luck if they took Dorca’s father elsewhere.

With the hospital scaling down operations and the island’s infrastructure on its knees, Gonzalez Cancel estimated he would not perform another open heart surgery for a month or more. His advice to the couple: leave.

“I am talking to you, not as a physician, I am talking to you as a human being,” he said. “Get him on a plane. You can be in Miami in two and a half hours.”

But of course, even leaving the island is a process fraught with difficulty.

With the island’s main airport still crippled, Gonzalez Cancel said he needed to secure a special waiver from authorities to obtain the medical evacuation flight for baby Gabriellyz. Travelers at the airport on Sunday were told that passengers who do not already have tickets may not be able to secure flights out until October 4.

With the situation on the island set to get worse before it gets better, some – Hillary Clinton among them – are calling on President Donald Trump to send the navy to Puerto Rico to help with the recovery effort. The devastation caused by Maria is similar to that wrought by hurricanes Katrina, Harvey and Irma, Reuters noted. But Puerto Rico’s remoteness and fragile infrastructure have made the logistics of organizing a disaster response very challenging.

Dr. Gonzalez Cancel also said the island needs the military to help with its recovery effort.

“We need a massive military response,” surgeon Gonzalez Cancel said. Because if more help doesn’t arrive soon, “people are going to start dying.”

Waiting for news about his father-in-law, Rivera, the Georgia resident and a 49-year-old Iraq War veteran, said the U.S. military could only do so much. He forecast the island would take months to get back on its feet.

“You need God pretty much to fix every light bulb,” he said.

Dr. Juan Carlos Sotomonte, the medical director of the Centro Medico‘s cardiovascular unit, said intervention – divine or otherwise – is needed fast.

“If this is not taken care of, people are going to start dying,” he said.

Making matters worse, the difficulties facing Puerto Rico’s hospitals may just be the calm before the storm. As supplies continue to dwindle and the island’s strapped finances hinder the recovery effort, the precarious situation facing Puerto Rico’s hospitals will probably worsen before it gets better.