The most recent blackout again disrupted lives, while exposing thousands to hazardous pollutants. “I was in Ponce and the sewage water was flooding the area,” recalled Ruth Santiago, an environmental lawyer at the Inter American University Law School in San Juan. “Schools are out. Courts are closed. The big mall is closed … The water pumps stop working because there’s no electricity, so raw sewage [was] backing up.”
The rolling blackouts and damaged infrastructure are just one component of the health-care situation. The Kaiser Family Foundation report highlights the accelerating outmigration since the storm and the resultant aging and sickening of the island’s population.“The Puerto Rican government projects a 10.9 percent cumulative decline in population over the six years following the hurricanes,” it said. An NPR story finds that among the remaining elderly residents, access to long-term support and nursing is declining.
KFF also reports that the physical health needs of those remaining on the island have increased since the storm. While major outbreaks have been contained or averted, “some individuals experienced worsened chronic conditions, such as diabetes and hypertension, due to gaps in care and medications following the storms.” With reduced access to quality food, exercise, and healthy lifestyle choices, stress-linked conditions like ulcers, orthopedic problems, and weight gain are increasing in prevalence. Other reports find that dialysis patients—especially in rural places where local hospitals have been destroyed or incapacitated—are facing worsening outcomes.
Perhaps the most alarming finding is the increased burden of mental-health problems following Hurricane Maria. KFF found “sharp increases in depression, anxiety, panic attacks, and post-traumatic stress disorder (PTSD) among the communities they serve.” Again, these problems heavily affected the most vulnerable. “Some interviewees pointed to ongoing emotional struggles among children, noting that some become very fearful and cry every time it rains,” the report notes.
Mental-health professionals are noticing a marked increase in suicides. According to the Kaiser Family Foundation, “from November 2017 through January 2018, a crisis hotline run by Puerto Rico’s Department of Health received 3,050 calls from people who said they had attempted suicide, a 246 percent increase compared to the same time last year. In the same three-month period, the hotline received 9,645 calls from people who said that they had thought about attempting suicide—an 83 percent jump from the same time last year.” These findings are supported by a March story from Quartz, which found suicides up by a third compared to the same time period in 2016.
This slowly unfolding public-health crisis lacks the drama of the major outbreaks predicted in the immediate aftermath of Hurricane Maria, but presents tremendous challenges. Still, it remains possible that an improved financial plan and outlook, along with increased access to sustainable energy, assistance from the federal government, and massive public-health campaigns from the Puerto Rican government, could combine to right the ship.