Tuesday, Jan. 30, 2018
An interdisciplinary team learned a great deal while providing care to storm-ravaged Puerto Rico last month. Perhaps two of the greatest lessons: Even months after the September storm caused a humanitarian crisis, the situation on the island is still changing rapidly and health needs — especially mental health needs — will continue for a long time.
The VCU team included Mark Ryan, M.D., a VCU School of Medicine alumnus and associate professor of family medicine and medical director of the International/Inner City/Rural Preceptorship program; Emily Peron, Pharm.D., assistant professor in the School of Pharmacy; School of Medicine students Gabriel Martinez Alvarez and Frank Soto del Valle; School of Pharmacy student Camilla De Jesus Pinero; and clinical psychologist Carla Shaffer, Ph.D.
Their plan was to spend the week of Dec. 16 at the Clinica Bantiox in Toa Baja, just west of San Juan. Ryan had visited the clinic in October and established a relationship with its organizers. But when the VCU team arrived, the patient load was significantly lighter, so the team partnered with Clinica Bantiox to expand the clinic’s reach into nearby barrios and mountain communities in the island’s center.
VCU students and faculty also worked with a clinic in Quebradillas on the western side of Puerto Rico. There, they managed acute and chronic care needs while listening to residents who needed to share stories and emotions.
Through their interactions with the community, they heard chilling stories about the devastation and its long-term effects.
“Absolutely everyone on the island was affected by the hurricane,” said Martinez Alvarez. “I was surprised by how evident the aftermath of the hurricane still is and how much recovery there still is to do.” Months after the hurricane, he said, electrical poles are down, debris is piled up and tarps cover many of the roofs. Many residents in the areas visited still don’t have potable water and must fill containers from streams.
Though Puerto Ricans’ most urgent medical needs may have been addressed for now, a slow-moving crisis still exists, Ryan said. “The emotional and psychological trauma is still a huge problem. We’re just seeing the tip of the iceberg.”
Shaffer agrees. “It was eye-opening to see firsthand that recovering from this storm wasn’t just a matter of recouping the tangible, it was also about rebuilding a sense of safety and normalcy.
“It really seemed life was on hold and they were finding a way for life to start moving again. I heard several people describe ‘it was like life was on standby’ and this sentiment still rang true even for those who felt the storm had spared them.”
Some residents, Shaffer added, found the months after the storm to be worse than the storm itself. “It’s the aftermath that feels harder to survive, harder still for those who had very little to begin with and continue to struggle without basic resources like electricity or water,” Shaffer said.
With the images of the island’s devastation still fresh, Ryan hopes to work with contacts in Puerto Rico and at VCU to see if an ongoing relationship can be developed to support the Puerto Rican community and give VCU faculty and students an opportunity to gain practical experience. One possibility could be partnering with a clinic in Quebradillas. Organizers hope the facility will become a fully functional hospital in a few years.
“It felt great to be able to contribute in a small way to the long and hard rebuild that Puerto Rico is going through,” Martinez Alvarez said, adding that the experience honed skills that will be valuable in his future as a physician. “It reinforced the importance of listening and taking into account situations and environments when treating patients’ conditions.”