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Evaluating Disaster Damages and Operational Status of Health-Care Facilities During the Emergency Response Phase of Hurricane Maria in Puerto Rico

Published online by Cambridge University Press:  29 October 2019

E.A. Irvin-Barnwell*
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
M. Cruz
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
C. Maniglier-Poulet
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
J. Cabrera
Affiliation:
Puerto Rico Department of Health, San Juan, Puerto Rico
J. Rivera Diaz
Affiliation:
Puerto Rico Department of Health, San Juan, Puerto Rico
R. De La Cruz Perez
Affiliation:
Puerto Rico Planning Board, San Juan, Puerto Rico
C. Forrester
Affiliation:
National Institute for Occupational Safety and Health, Washington, DC
A. Shumate
Affiliation:
National Institute for Occupational Safety and Health, Washington, DC
J. Mutter
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
L. Graziano
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
L. Rivera Gonzalez
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
J. Malilay
Affiliation:
Agency for Toxic Substances and Disease Registry/National Center for Environmental Health, Atlanta, Georgia
M. Raheem
Affiliation:
Office of the Assistant Secretary for Preparedness and Response, New York, New York
*
Correspondence and reprint requests to Elizabeth Irvin-Barnwell, 4770 Buford Highway, NE; MS S-102; Atlanta, GA, 30341 (e-mail: jcx0@cdc.gov).

Abstract

On September 20, 2017, Hurricane Maria made landfall on Puerto Rico as a category 4 storm, resulting in serious widespread impact across the island, including communication and power outages, water systems impairment, and damage to life-saving infrastructure. In collaboration with the Puerto Rico Department of Health, the Public Health Branch (PHB), operating under the Department of Health and Human Services Incident Response Coordination Team, was tasked with completing assessments of health-care facilities in Puerto Rico to determine infrastructure capabilities and post-hurricane capacity. Additionally, in response to significant data entry and presentation needs, the PHB leadership worked with the Puerto Rico Planning Board to develop and test a new app-based infrastructure capacity assessment tool. Assessments of hospitals were initiated September 28, 2017, and completed November 10, 2017 (n = 64 hospitals, 97%). Assessments of health-care centers were initiated on October 7, 2017, with 186 health-care centers (87%) assessed through November 18, 2017. All hospitals had working communications; however, 9% (n = 17) of health-care centers reported no communication capabilities. For the health-care centers, 114 (61%) reported they were operational but had sustainment needs. In conclusion, health-care facility assessments indicated structural damage issues and operational capacity decreases, while health-care centers reported loss of communication capabilities post-Hurricane Maria.

Type
Original Research
Copyright
© 2019 Society for Disaster Medicine and Public Health, Inc.

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References

REFERENCES

Noji, EK.The public health consequences of disasters. Prehosp Disaster Med. 2000;15:147157.10.1017/S1049023X00025255CrossRefGoogle ScholarPubMed
Ochi, S, Kato, S, Kobayashi, KI, et al. The great East Japan Earthquake: analyses of disaster impacts on health care clinics. Disaster Med Public Health Prep. 2018;12:291295.10.1017/dmp.2017.82CrossRefGoogle ScholarPubMed
Matsumura, T, Osaki, S, Kudo, D, et al. Water supply facility damage and water resource operation at disaster base hospitals in Miyagi Prefecture in the wake of the Great East Japan Earthquake. Prehosp Disaster Med. 2015;30:193198.10.1017/S1049023X15000084CrossRefGoogle ScholarPubMed
Kirsch, TD, Mitrani-Reiser, J, Bisseli, R, et al. Impact on hospital functions following the 2010 Chilean earthquake. Disaster Med Public Health Prep. 2010:4;122128.10.1001/dmphp.4.2.122CrossRefGoogle ScholarPubMed
The Joint Commission. Emergency Management in Health Care: An All-Hazards Approach. 2nd ed. Oakbrook Terrace, IL: The Joint Commission Resources; 2012.Google Scholar
Nates, JL.Combined external and internal hospital disaster: impact and response in a Houston trauma center intensive care unit. Crit Care Med. 2004;32:686690.10.1097/01.CCM.0000114995.14120.6DCrossRefGoogle Scholar
Norcross, ED, Elliott, BM, Adams, DB, et al. Impact of a major hurricane on surgical services in a university Hospital. Am Surg. 1993;59:2833.Google Scholar
Tran, P, Weireter, L, Sokolowski, W, et al. HAZUS modeling for hurricane effect on a health care campus: implications for health care planning. Am Surg. 2009;75:10591064.Google ScholarPubMed
Downey, EL, Andress, K, Schultz, CH.Initial management of hospital evacuations caused by Hurricane Rita: a systematic investigation. Prehosp Disaster Med. 2013;28:257263.10.1017/S1049023X13000150CrossRefGoogle ScholarPubMed
NOAA. National Hurricane Center. Hurricane Maria. http://www.nhc.noaa.gov/archive/2017/al15/al152017.update.09201034.shtml. Accessed November 2017.Google Scholar
FEMA. Hurricane Maria. Statistics Progress in Puerto Rico. https://www.fema.gov/hurricane-maria. Accessed November 2017.Google Scholar
Malilay, J.Public health assessments in disaster settings: recommendations for a multidisciplinary approach. Prehosp Disaster Med. 2000;15:167172.10.1017/S1049023X00025279CrossRefGoogle ScholarPubMed
Malilay, J, Heumann, M, Perrotta, D, et al. The role of applied epidemiology methods in the disaster management cycle. Am J Public Health. 2014;104:20922102.10.2105/AJPH.2014.302010CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (CDC). Hurricane Ike rapid needs assessment - Houston, Texas, September 2008. MMWR Morb Mortal Wkly Rep. 2009;58:10661071.Google Scholar
Cruz, MA, Garcia, S, Chowdhury, MA, et al. Assessing the congregate disaster shelter: using shelter facility assessment data for evaluating potential hazards to occupants during disasters. J Public Health Manag Pract. 2017;23:5458.10.1097/PHH.0000000000000445CrossRefGoogle ScholarPubMed
Ardalan, A, Kandi Keleh, M, Saberinia, A, et al. 2015 estimation of hospitals safety from disasters in I.R.Iran: the results from the assessment of 421 hospitals. PLoS One. 2016;11:e0161542.10.1371/journal.pone.0161542CrossRefGoogle ScholarPubMed
Djalali, A, Ardalan, A, Ohlen, G, et al. Nonstructural safety of hospitals for disasters: a comparison between two capital cities. Disaster Med Public Health Prep. 2014;8:179184.10.1017/dmp.2014.21CrossRefGoogle Scholar
Bulson, J, Bulson, T. How can hospitals be better prepared? A case study of an exercise design program and its effect on a real-life event. J Healthc Prot Manage 2010;26:8994.Google Scholar
HHS. Public health emergency. HHS Concept of operations for ESF-8. https://www.phe.gov/Preparedness/planning/mscc/handbook/chapter7/Pages/hhsconcept.aspx. Accessed January 2018.Google Scholar
Deitchman, S.What have we learned? Needs assessment. Prehosp Disast Med. 2005;20:468470.10.1017/S1049023X00003149CrossRefGoogle ScholarPubMed