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Health Care Needs in the Aftermath of Hurricane Maria in Puerto Rico: A Perspective from Federal Medical Shelter Manatí

Published online by Cambridge University Press:  15 April 2021

Arnab K. Ghosh*
Affiliation:
Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New YorkUSA
Max Mecklenburg
Affiliation:
Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New YorkUSA
Said Ibrahim
Affiliation:
Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, New YorkUSA
Pia Daniel
Affiliation:
Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New YorkUSA
*
Correspondence: Arnab K. Ghosh, MD, MSc, MA Department of Medicine Weill Cornell Medical College Cornell University 525 E 68th St., New York, New York, USA10065 E-mail: akg9010@med.cornell.edu

Abstract

Introduction:

On September 20, 2017, Hurricane Maria, a Category 4 hurricane, swept across Puerto Rico (PR), wreaking devastation to PR’s power, water, and health care infrastructure. To address the imminent humanitarian crisis, the US government mobilized Federal Medical Shelters (FMS) to serve the needs of hurricane victims. This study’s objective was to provide a description of the patients seeking emergency care at FMS and the changes in their needs over time.

Methods:

This retrospective, cross-sectional study included all patients presenting to the FMS Manatí from October 6, two weeks after Hurricane Maria’s landfall, to November 2, 2017. Categories were created to catalogue the nature of new acute medical issues by patients presenting to the Shelter. Descriptive, graphical analyses were performed to assess changes to presenting complaints over time, and by age groups defined as infant (age ≤1 years), child (1 year < age ≤10 years), adolescent (10 years < age ≤ 25 years), and adult (age > 25 years).

Results:

Over the 30-day period, 5,268 patients were seen in the FMS seeking medical care (average 188.1 patients per day), spending less than five hours in the facility. The distribution of patients’ age was bimodal: the first peak at one year and the second at age 50. The most common patient complaint was infection (38.8%), then musculoskeletal (MSK) complaints (11.8%) and management of chronic medical conditions (11.8%). The proportion of patients presenting with chronic disease complaints declined over the course of the period of observation (21.4% on Day 4 to 8.0% on Day 30) while the proportion of patients presenting with infection increased (31.0% on Day 4 to 48.6% on Day 30). Infection complaints were highest in all age groups, but most in infxants (80.2%), while MSK and chronic disease complaints were highest in adults (14.9% and 14.9%, respectively).

Conclusion:

Infection treatment and chronic disease management were important medical needs facing patients seeking care at FMS Manatí after Hurricane Maria. These findings suggest that basic needs related to sanitation and shelter remained important weeks after the hurricane, and a focus on access to medications, infection control, and injury prevention/management after a disaster needs to be prioritized during disaster response.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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