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Monday Apr 02, 2018

Don't Forget Puerto Rico -- We Didn't

It has been six months since Hurricane Maria hit Puerto Rico, and yet so many things have not changed for Ana. She lost electricity when the first strong winds hit, the night before the storm made landfall on Sept. 20, and the worst was yet to come.

Hurricane Maria makes landfall near Yabucoa, Puerto Rico. The Category 4 hurricane devastated the island on Sept. 20, 2017.

Although Ana, who prefers to be identified here only by first name, had power back 41 days after the storm, her water supply remained intermittent, and she typically had running water for only two to three hours per day. She had lost her job just before the disaster, and with so many others looking for work in the wake of the hurricane, it became nearly impossible to even get an interview.

Jose Caceres had not fared much better. He finished medical school and was scheduled to take Step 1 of the United States Medical Licensing Examination (USMLE) on Dec. 5, but with ongoing infrastructure problems -- 12-hour waits for gasoline are common -- the USMLE test in San Juan was canceled. And the storm-damaged facility where he worked, Hospital Menonita, laid off 200 employees -- including Jose -- because much of the facility's infrastructure wasn't functional after the storm. The hospital's generators worked in the immediate aftermath of the storm, but they were not engineered to run 24/7 for months while the power grid was damaged. One by one, generators started to fail after months of non-stop use.

Nearly 3,000 miles away at Miramont Family Medicine in Fort Collins, Colo., X-ray technologist Ashley Delgado was concerned about her grandparents who live in Puerto Rico. Ashley had lived on the island as a child and wanted to do something to help, and so did I.

Ashley, her husband and two other staffers, including a cameraman, made an expedition to the stricken island with medical supplies donated by one of our vendors, Medline Industries of Northfield, Ill. We learned that one of the hospitals, Ryder Memorial Hospital in Humacao, had been hit hard and was running on generators, and staff there agreed to accept our donations.

On location in San Juan, our team also reviewed job applications from more than 300 people who wanted to interview for the two new positions we had created back home: a medical assistant and a medical host. Under our displaced-worker program, Miramont offered round-trip airfare, housing and a company vehicle for six months so the employees could save income until the island infrastructure improved enough that they might return home.

Ultimately, we hired Ana and Jose.

Hurricane Maria was the worst natural disaster on record in Dominica and Puerto Rico, the 10th most intense Atlantic hurricane on record, and the most intense tropical cyclone worldwide of 2017. Maria caused more than $90 billion of damage(www.nhc.noaa.gov) and took the lives of hundreds of people.(www.pbs.org) Although the full devastation was immeasurable, the people of Puerto Rico -- with the help of the Federal Emergency Management Agency, the Red Cross and others -- worked to repair the damage left by this powerful storm.

Last year was the costliest hurricane season in U.S. history as Harvey, Irma and Maria inflicted damage on Florida, Puerto Rico, Texas and the U.S. Virgin Islands. The AAFP Foundation responded by providing more than $120,000 in disaster relief aid to those in need, including $22,000 to hurricane victims in Puerto Rico, $10,000 to the Puerto Rico AFP and six $2,000 disaster assistance grants to AAFP members in Puerto Rico. Thank you to all our AAFP member donors for your generosity! The Foundation is still accepting donations for relief efforts.(www.aafpfoundation.org)

Our constituent chapters also rallied. Kim Yu, M.D., past president of the Michigan AFP, worked with the Indiana AFP and other chapters to raise more than $102,000, including a $25,000 contribution from the AMA, to purchase 66 generators and other supplies for family medicine clinics in Puerto Rico. The Kansas and California chapters, among others, also raised funds for disaster relief last year.

Hurricane Maria devastated Puerto Rico, but my wife, Teresa, and I have been blessed to host Jose and Ana, who started their employment at Miramont Family Medicine in January. Jose will take his USMLE Step 1 exam in May. Ana has a bachelor's degree and plans to work as a therapist. They are working as a medical assistant and hostess, respectively, until they earn their certifications.

"Our reality right now, we will be OK," Jose said. "It is very hard. Every part of the world has their problems. California had their fires, their earthquakes. Now it was our time for a big thing, and it was a really a big thing. We will get there."

As for Ana, "I am one of the lucky ones," she said.

For those who remain in Puerto Rico, however, there is still a long road to recovery, and the island still needs our help.

John Bender, M.D., M.B.A., is a member of the AAFP Board of Directors.

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