Standing in front of Black River Hospital after Hurricane Melissa tore across Jamaica, Luis David Rodriguez was horrified.

“It’s by far the most destruction we’ve seen here thus far,” said Rodriguez, a Direct Relief emergency response manager who’s currently evaluating medical needs in Jamaica. “The hospital is standing but it’s in pretty bad shape.”

Ivonne Rodriguez-Wiewall, a Direct Relief consultant who’s responded to numerous Caribbean emergencies and who traveled to Jamaica as part of the emergency team, described a shattered dialysis facility, also in Black River, that was managing to still serve patients in the tiny space that was still whole.

“It’s completely destroyed,” she said of the building. “It only has one place where the patients are, with a generator working only the equipment.”

The Pan American Health Organization, the regional WHO office and long-term Direct Relief partner, has documented a range of severe damage to hospitals, clinics, and other health infrastructure across Jamaica. In St. James, the roof of the children’s ward at Cornwall Hospital collapsed – one of five hospitals with severe damage. At least 15 facilities across the country experienced significant damage during the Category 5 storm, and 11 are remaining open without even a full day’s worth of medicines and other essential resources.

For Rodriguez-Wiewall and Rodriguez, both Puerto Ricans who have responded extensively after a number of hurricanes, including 2017’s Hurricane Maria, much of what they have seen is familiar: tattered, flooded communities, shocked faces, and many examples of everyday heroism.

“Walking through the streets of Montego Bay and Saint Elizabeth reminded me so much of what we lived through in Puerto Rico after Hurricane Maria,” Rodriguez-Wiewall said. “The destruction is immense, and many families have lost their homes, their medications, and the basic essentials they depend on.”

She described children helping their parents clear mud and debris. One older man told her he’d been unable to take his blood pressure medication for days. The local clinic was closed and the pharmacy had flooded.

However, Rodriguez-Wiewall noted, the same sense of community and concern for others is a feature of Jamaica’s response to the disaster: “Just like in Puerto Rico, there’s a powerful spirit of resilience here, people helping one another and determined to rebuild.”

Providers working in the small area of the dialysis facility still standing were caring for patients who had gone nearly a week since their last treatment. Dialysis must typically be completed three times a week for patients with serious kidney disease. But the generator was only sufficient to power the dialysis machines themselves.

“These are patients who have not received their dialysis since the hurricane passed,” Rodriguez-Wiewall reported.

Rodriguez described providers still working at Black River Hospital, with no power. “We gave them the medical backpack we had,” he said.

Direct Relief has a wide network of partnerships with Jamaica, including with the country’s Ministry of Health and Wellness. Rodriguez-Wiewall and Rodriguez were delighted to learn that Direct Relief’s medical aid was familiar in Black River – including the organization’s distinctive orange-and-black field medic packs.

“She recognized the backpacks,” Rodriguez recalled of one aid worker.

Many communities have been cut off both from aid and communications. Hurricane Melissa flooded and blocked roads, and downed power and internet, all over Jamaica.

But Rodriguez-Wiewall said public agencies had been quick and effective at clearing roads and establishing lines of communication.

“Today we crossed from Kingston [Jamaica’s capital] all the way to Black River,” a city in Jamaica’s southwest, she explained. While Kingston was relatively intact, Black River, about 12 miles away, had been devastated. “We had to go around if there was flooding or bypasses, but we were able to make it.”
Montego Bay, a city in the north of Jamaica, was similarly devastated, Rodriguez-Wiewall reported after conducting an evaluation.

Direct Relief has launched a multifaceted response to Hurricane Melissa. Prepositioned supplies have been deployed in Jamaica, Haiti, and the Dominican Republic. A large-scale cache of emergency supplies, which Direct Relief positioned in the Pan American Health Organization’s facilities in Panama, has been deployed regionally.

Rodriguez-Wiewall and Rodriguez plan to meet a new Direct Relief shipment in Kingston, scheduled to arrive this week. The shipment contains 100 additional field medic packs, designed for first responders caring for patients in emergent circumstances, and a large variety of hygiene items for displaced people. These items are intended to prevent diseases caused by lack of sanitation, such as cholera and scabies, both serious risks in the aftermath of disasters.

A far more extensive shipment, containing water purification tablets, oral rehydration solutions, diabetes medicines and supplies, IV items, insect repellent, reentry kits for people returning to damaged, homes, prenatal vitamins, and mental health medications, among other medical aid, is en route.

A $50,000 emergency grant will be awarded to the JAHJAH Foundation, a nonprofit working on the ground in impacted Jamaican communities to meet health, water, and other essential needs. Direct Relief staff visited JAHJAH Foundation staff to evaluate medical needs and see their operations at work.

Direct Relief staff are conferring with local health systems and providers to determine what medical aid and funding allocations will be most effective at preventing the serious health impacts caused by hurricanes.

Rodriguez-Wiewall cautioned that needs would be extensive and likely long-lasting. While government agencies and regional groups have launched fast, coordinated responses, the scale and severity of Hurricane Melissa meant that many people have gone too long without food, clean water, or emergency care. Jamaican partners have reported that bodies are continuing to be uncovered.

“There are a lot of people walking by with needs for food and water,” Rodriguez-Wiewall said, describing conversations she’d had in affected Jamaican communities. “They need everything. They’ve lost everything.”