With Vulnerable Community Still Underwater, Puerto Rico Health Center Working Overtime

Florida Medical Center employees walk through a home in the Parcelas Selgas neighborhood of Florida, Puerto Rico, where water lines on the walls indicate how high storm waters rose. The entire first story of the home was swamped when Maria made landfall. Deep standing water, filled with sewage and trash, still remains in the neighborhood and worries doctors, who are already seeing an increase in stomach illnesses because of poor water quality. (Lara Cooper/Direct Relief)

What was once a neighborhood with a small stream running through it is now a fetid lake that has swamped homes and presents a major health concern for residents.

On Friday, trash floated through the murky green waters that have filled up homes in the Parcelas Selgas neighborhood of Florida, Puerto Rico, a municipality with the same name as the U.S. state and which sits two hours west of San Juan on the island’s north coast.

The neighborhood is home to many living in poverty, many of whom are elderly and still living in their homes, even as the waters still fill entire stories of the homes around them.

Elderly residents return to Parcelas Selgas neighborhood to find their homes still underwater, more than three weeks after Hurricane Maria made landfall. Public health officials have already seen health impacts from the standing water, which is filled with sewage and trash. (Lara Cooper/Direct Relief)

The neighborhood’s septic systems overflowed into the water after the storm, contaminating the water and causing concern for the staff of a nearby health clinic.

The staff at Florida Medical Center said they’ve already seen patients come to their clinic with gastrointestinal illnesses caused by the compromised water supply. The standing water is also a breeding ground for mosquitoes, and the clinic staff are concerned about an increase in mosquito-borne diseases like Zika, Dengue and Chikungunya.

Now, a large pump works around the clock to empty the water, but the amount dwarfs the efforts to empty it. The water marks can be seen on the walls inside the homes, and some of the muddy lines across the walls start as high as six inches from the ceiling.

When Hurricane Maria made landfall, more than 15 feet of water rose into nearby homes. Three weeks later, the water has receded but still remains a public health threat. (Lara Cooper/Direct Relief)

The fact that many people are still occupying the homes concerns the staff, and Daniel Ramos of the Puerto Rico Primary Care Association. He’d come to the community to deliver insulin and emergency medicines from Direct Relief to nearby Florida Medical Center, which sits just a few blocks away from the swamped neighborhood.

“This is a big risk for the community,” said Ramos. “The water is not good.”

People are still living in unflooded portions of their homes, even as the water inundates the first floors of the buildings.

“They have nowhere else to go,” he said.

Down the street, the medical center is working to treat patients from this neighborhood and the rest of the Florida community.

Puerto Rico Primary Care Association’s Daniel Ramos and staff at the Florida Medical Center share a laugh in the center’s pharmacy after medicines and insulin were delivered Friday. (Lara Cooper/Direct Relief)

The center has a small pharmacy, with staff working overtime to keep patients stocked with enough medicine. Looking forward, the staff anticipates a great need for saline solutions to treat those dehydrated by stomach illnesses.

The health center is absorbing patients that would normally be seen by primary care doctors in the area, whose practices are now shuttered for lack of power.

Downed power lines are ubiquitous throughout Puerto Rico. These lines block the road near the Atlantic Medical Center in Barceloneta, Puerto Rico, a neighboring community of Florida . (Lara Cooper/Direct Relief)

The nearest hospital is 20 minutes away, and that’s without traffic, fallen trees or power lines, said Rosa Agostini, the center’s CEO. The center is also seeing sicker patients, since many have been unable to manage their diabetes.

Direct Relief delivered a shipment of insulin to the clinic, as well as Emergency Health Kits, filled with medicines like antibiotics, and water purification supplies.

Florida Medical Center staff inventory insulin delivered Friday. (Lara Cooper/Direct Relief)

The infusion of insulin will be used to treat patients coming through the clinics doors. About 17 percent of the clinic’s patients have been diagnosed with diabetes, and since many are living without power, pharmacists help the patients learn some tricks to preserve their insulin.

Ice packs and cold water do the job, and the pharmacists teach patients how to change the water periodically to keep the insulin cool.

The center is running on a large generator fueled by diesel, and is one of the few buildings in the community with power, making it a refuge for patients, many of whom sit on the floor by power strips to charge their phones while they wait for appointments.

The medicines delivered Friday to Florida Medical Center were just one of a dozen deliveries to go out that day to health clinics in different parts of the island.

Each community, like Florida, has health staff working overtime to address health concerns that would go uncared for, were they not there with their doors open. Now, their pharmacy shelves are bit deeper with needed medicines.