BY SEBASTIAN A. CORDERO MUNIZ
In the Caribbean Sea Southwest of Miami, the island of Puerto Rico lies at the convergence of Latin America and the United States. Despite its uniquely hybrid culture and heritage, beautiful beaches, and close connection to the United States, Puerto Rico faces many long standing challenges. With a bankrupt government, a shortage of skilled professionals, and an aging population, Puerto Rico’s economic and public systems face a bleak future. These compounding crises have resulted in Puerto Rico having a poverty rate roughly two times that of Mississippi and in 90% of Puerto Ricans being insured by either Medicaid or Medicare [1]. To make matters worse, Puerto Rico, and especially its healthcare system, is severely underprepared to tackle and withstand these rising threats of climate change, and recent hurricanes have made this clear. This essay will examine the impacts of Hurricane Maria on Puerto Rico’s healthcare system and explore potential solutions to improve climate resilience in the face of an increasingly hostile climate.
In September 2017, Hurricane Maria struck the island, and Puerto Rico was suddenly cut off from the rest of the world and forced to fend for itself. The hurricane caused widespread infrastructure damage, preventing access to critical facilities, such as hospitals. Power outages and a lack of sufficient supplies limited hospital capacities. Clean water and safe food, a privilege once taken for granted, became a deep concern for Puerto Ricans. All of these issues compounded on the already stressed health and public services of the island, creating a health crisis not seen in decades. This crisis was particularly damaging because it was a two-sided problem. Patients could not access care, and providers did not have the resources to provide care. In the end, over 4,000 Puerto Ricans died, either by the hurricane directly or its far-reaching effects [1].
Eventually, the immediate dangers subsided, but this only revealed the structural, longer-term effects of the hurricane, which have proven to be even more challenging to solve. Health-wise, the implications were four-fold. First, mental health problems and trauma rose roughly 30% after the hurricane [2] and have not declined to pre-Hurricane Maria levels. Second, people with once-treatable conditions face worsened health prospects as a result of not being treated during the hurricane’s aftermath [3]. Third, while infrastructure was replaced, it was mostly short-term replacements of lackluster quality, leading to persistent outages with the electrical grid that frequently disrupt services even today [4]. Finally, the hurricane spurred even more emigration from the island with roughly 130,000 Puerto Ricans, often highly-skilled professionals who can easily find employment in the mainland, leaving the island in the aftermath [4], increasing the burden on medics that stay on the island and further diminishing the quality of care for patients. Overall, the population has not recovered from Hurricane Maria and continues to struggle in rebuilding the healthcare system.
To escape these calamities, effective and targeted actions are necessary. First, the manner in which federal funding is distributed to Puerto Rico should be changed, modeling it after how states are funded. This will provide stable and consistent funding for Puerto Ricans, helping solve the financial crisis in Puerto Rico and ensuring that Puerto Ricans have access to the same rights and services as other Americans. Second, policies, such as free medical or nursing school, loan forgiveness, and targeted scholarships, should be implemented to increase the number of professionals that study and remain on the island long-term to serve the population. Third, heavy investment must be made on the energy, telecommunications, and transportation infrastructure systems to make them modern, efficient, sustainable, and climate-resilient. Improved climate resilience will prepare the island for future storms and limit the number of critical health services canceled during emergencies. Evidently, change can be made. Unfortunately, given Puerto Rico’s economic challenges and a nonchalant US federal government, it is difficult to envision how these problems will ever be adequately solved without significant intervention and institutional overhaul, leaving Puerto Ricans vulnerable to future natural disasters and perpetuating the island’s cycle of crises.
Sebastian A. Cordero Muniz is a sophomore in Ezra Stiles College.
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References
- Behling-Hess, C. (2019). Healthcare in Puerto Rico: Before and After Hurricane Maria. Public Health in Latin America.
https://sites.google.com/macalester.edu/phla/key-concepts/healthcare-in-puerto-rico-before-and-after-hurricane-maria - Chandra, A., et al. (2021, August 16). Health and Social Services in Puerto Rico Before and After Hurricane Maria. Rand Health Quarterly, 9(2), 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383835/
- Mozumder, P., et al. (2023). Assessing Impacts of Hurricane Maria for Promoting Healthcare Resilience in Puerto Rico. Natural Hazards Center. https://hazards.colorado.edu/public-health-disaster-research/assessing-impacts-of-hurricane-maria-for-promoting-healthcare-resilience-in-puerto-rico
- Guerra Velazquez, G. R. (2022, September 23). Hurricane María and Public Health in Puerto Rico: Lessons Learned to Increase Resiliency and Prepare for Future Disasters. Annals of Global Health, 88(1), 82. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504014/
Yale Global Health Review 