Puerto Rico is now ground zero for U.S. emergency response and public health efforts to avert a worsening humanitarian crisis. Puerto Rico, the U.S. Virgin Islands and other parts of the Caribbean endured near total devastation of infrastructure, electricity supply and, insidiously, healthcare systems, caused by Hurricanes Irma and Maria. Hurricane Maria, the most powerful storm to hit Puerto Rico in more than 80 years, was just 1 mile below a category five storm sparing no part of the island. Puerto Rico’s already dilapidated infrastructure and downtrodden people, 3.4 million American citizens, were ill-prepared for this devastating event. Now that relief efforts are underway and the island struggles through months to get the electricity grid back to full capacity, efforts must now turn to the crippled healthcare system to avoid a prolonged public health crisis.
Given Hurricane Maria’s strength and island-wide devastation, the official loss of life from the storm at 64 people, is mercifully low, although marred by a growing cloud of inaccuracy. This speaks to the general level of “weather readiness” among the island’s inhabitants. However, many more lives are at risk in the aftermath of Hurricane Maria than during the worst of the storm. This harsh reality is caused, in no small measure, by the otherwise idyllic subtropical climate in the Caribbean, the dilapidated state of the healthcare system, and the slow response from Federal authorities in the aftermath. As a result, reports suggest these factors have conspired to claim anywhere between 64 and 900 lives, largely due to medically preventable and treatable diseases. There is also a corresponding increase in crime and violence as the lines between the haves and have nots have been illuminated by the gated communities with generators, while the rest of the island lives in dark, squalid conditions.