An investigation by the Center for Investigative Journalism in Puerto Rico has revealed that nearly 1,000 more people died in the 40-day period after Hurricane Maria hit Puerto Rico compared to that same time period last year. These findings sharply contradict the storm’s “official” death toll of 62. The government allowed 911 bodies to be cremated without being physically examined by a government medical officer to determine if they should be included in the official death toll from the storm. Each cause of death was listed as being of “natural causes.”
The revelation of the new data also coincides with accounts from relatives’ reports of victims that point to problems with essential health services such as dialysis, ventilators, oxygen, and other critical circumstances caused by the lack of electricity in homes and hospitals throughout Puerto Rico.
The majority of the deaths were men and women over 50 who died in hospitals and nursing homes from conditions such as diabetes, Alzheimer’s, kidney disease, hypertension, pneumonia and other respiratory diseases. When compared to the same time period from 2016, there was a significant increase in deaths, especially in hospitals and nursing homes.
Some have said they considered heart attacks and people who died of lack of oxygen because of lack of power as hurricane-related deaths, while others said they considered those “natural causes.” Accurate information about the death toll is important because it allows victims’ families to claim federal relief aid. It has also been used as a measure of how effective relief efforts have been. The official death toll likely fails to take account of all those who died as a result of the deadly hurricane.
Demographer José A. López, the only person at the registry in charge of analyzing this data, has said that the increase in deaths in the first two post-Maria months is significant and the government’s inability to link more deaths to the hurricane shows that the current process of documenting causes of death in a disaster is not working and must be reformed. López and the Department of Health appeared before Puerto Rico’s Senate to request that a dialogue begin about the issue and that they lead to changing the system.
Currently, linking a death to a disaster depends almost exclusively on a physician making an annotation related to the hurricane in the death certificate and listing the clinical cause of death, but both doctors and hospitals maintain that their responsibility and knowledge are strictly tied to the clinical cause of death. In most cases, the doctor who certifies the death may not be the same doctor who was in charge of the patient. Because of this, most death certificates do not include additional information about the other circumstances that could lead to death — such as the stress caused by an emergency; lack of power, transportation services or medications; lack of access to health services; changes in diet; and increases in ambient temperatures, among others.