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.
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The White House requested Congress approve $44 billion in disaster relief in what would be the largest single round of disaster aid to address the widespread damage inflicted by hurricanes and wildfires over the last three months. It is the third request since hurricanes Harvey, Irma and Maria slammed the Gulf Coast and Caribbean. The new request would add another $24 billion to the disaster relief this fall and bring the total close to $100 billion. It would also establish a new $12 billion grant program for flood risk mitigation projects. Smaller amounts would go to small business loans and to aid farmers suffering crop losses.
The White House is proposing the increased funding be offset by cuts to federal programs in hopes to deter members from Congress who might not vote for a disaster assistance package that adds to the deficit. Two previous disaster relief bills totaling nearly $51.8 billion that Congress approved earlier this year had no such offsets.
And that’s before most of the money to rebuild Puerto Rico’s devastated housing stock and electric grid is added in. Puerto Rican Gov. Ricardo Rosselló has asked the federal government for $94.3 billion in disaster relief funds to help repair critical infrastructure and rebuild housing following Hurricane Maria. He said the sum will help the U.S. territory adequately recover from Hurricane Maria. Over half of Puerto Rico is still without power almost two months after Hurricane Maria made landfall. More than 10 percent of the island is still without running water.
The largest chunk of Rosselló’s request, $31 billion, goes to housing assistance with $17.7 billion to rebuild the island’s power grid and $14.9 billion for health care. “This is a critical step forward in the rebuilding of Puerto Rico where we’re not only looking to rebuild as was before but we want to make it much stronger and much more resilient and make Puerto Rico a model for the rest of the Caribbean,” Rosselló said. Ricardo Rosello also urged Congress to adopt a tax overhaul plan that addresses the territory’s specific needs to avoid an exodus of the companies that currently generate 42% of the island’s gross domestic product.
The relief request is over $30 billion more than a $61 billion relief request from Texas Gov. Greg Abbott after Hurricane Harvey flooded parts of metro Houston and East Texas. The Florida congressional delegation has asked for $27 billion. It is likely that Congress will pare down the amount as they did after Hurricane Sandy in 2012.
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People fill containers with water from a stream near the Puerto Rico Highway 52 in Cayey on Tuesday. People have been without water service in their homes after Hurricane Maria roared through a week ago.
Three weeks after Hurricane Maria hit Puerto Rico as a Category 4 storm, officials are warning the island’s health system is in dire condition as the island still has severely limited electricity and running water. Many residents have contracted bacterial diseases, likely as a result of their exposure to contaminated floodwaters but without electricity and clean water-treatment is scarce. The official death toll from Hurricane Maria has now risen to 45.
Hurricane Maria knocked out the water system for more than half the island’s 3.4 million people, leaving many reusing what little water they can get their hands on. Medical experts say it is one of the factors that make them deeply concerned over a possible spike in infectious diseases in coming weeks. Twenty of the island’s fifty-one sewage treatment plants are still out of service allowing raw sewage to contaminate rivers, streams and reservoirs. Those without running water bathe and wash their clothes in contaminated streams, and some islanders have been drinking water from condemned wells.
Nine out of 10 homes on the island still have no electricity, leaving fans and air conditioning units unavailable to stave off mosquitos carrying illness in the storm’s aftermath. Neither electricity nor running water is expected to be fully restored for months. The Federal Emergency Management Agency says 64 of the island’s 68 hospitals are open but only 25 are hooked up to the power grid. The remaining hospitals are running off of generators that aren’t meant to be used for such long periods and rely on erratic diesel supplies.
Some 11,000 U.S. military personnel have come to Puerto Rico in the wake of Hurricane Maria, and convoys of military vehicles carrying pallets of bottled water and meals are visible in the interior. Mosquito control units deployed in six municipalities, officials said, and five temporary biomedical waste stations have been set up.
FEMA has 16,000 federal and military assets are on the ground in Puerto Rico and about 350,000 Puerto Ricans have registered so far in the FEMA system to receive financial assistance. Roads and highways have been washed out, hampering relief efforts to the interior of the island. Some remote areas have not received any help since the storm. Food and basic supplies remain scarce in the mountainous interior making the threat of waterborne diseases grow.
Authorities hope the arrival of the USNS Comfort will help ease problems at hospitals around the island. The hospital ship has one of the largest trauma facilities in the United States and is equipped with three operating rooms, 50 ICU beds along with another 200 other beds, and some 500 medical personnel. Two MH-60 helicopters sit on its landing-pad deck.
The ship will treat patients and also provide services to other hospitals such as refilling tanks for medical-grade oxygen and re-sterilizing hospital gear. The ship’s staff had already treated 64 patients shortly after its arrival and medical personnel expected to see many others with chronic conditions, such as diabetes, hypertension and lung problems.
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