By Don McIntosh
By night they slept on army cots in a baseball stadium. By day, they brought medical attention to stricken communities. Six Kaiser Permanente nurses are now returning to Portland after spending two weeks in Puerto Rico with 300 other union volunteers from around the country— helping residents cope with the aftermath of a Category 5 hurricane.
Hurricane Maria hit Puerto Rico Sept. 20 with winds of up to 155 miles per hour. It battered the island for more than 30 hours, dropping up to 37 inches of rain — as much as Houston got over three days from Hurricane Harvey. The electric grid was devastated, leaving Puerto Rico’s entire population of 3.4 million without power. Roads were out, and communications were down, with up to 85 percent of the island’s cell towers out of service. Several million people were without access to safe drinking water.
Six days after the hurricane, labor leaders in Puerto Rico set up a phone call between the mayor of San Juan and national AFL-CIO President Richard Trumka. Trumka called Sara Nelson, president of the Association of Flight Attendants union, and she called the CEO of United Airlines. They worked out a deal: If AFL-CIO unions could recruit 300 skilled union volunteers, United would fly them to San Juan and back. Within days, unions found about 100 health care workers, 100 building trades workers, and 100 Teamsters who were willing to drop everything and leave home for two weeks. Two weeks after Maria hit, a Boeing 777-300 flew them from Newark to San Juan. The charter flight was crewed and loaded by union volunteers, and it carried 17 tons of donated supplies. On board were volunteers from 20 unions, including nurses, doctors, electricians, operating engineers, carpenters and truck drivers.
Among them were four nurse practitioners and two registered nurses from Oregon Federation of Nurses and Health Professionals (OFNHP) Local 5017, an affiliate of American Federation of Teachers. At the union’s request, Kaiser Permanente agreed to release them from duty for the duration, but it was unpaid service: Moved to action by the enormity of the disaster, some gave up two weeks pay; others used vacation time.
Arriving in San Juan, they boarded buses and got a police escort to the sports complex that served as command central. For the next two weeks, women union volunteers slept in locker rooms in the Hiram Bithorn baseball stadium, while men slept in hallways in the adjacent Roberto Clemente Coliseum. In a covered area of the baseball stadium, they bonded over shared meals eaten together as a group: beans and rice for dinner, and ham and cheese sandwiches for breakfast and lunch. Frills included running water, showers, and intermittent electricity and air conditioning. But that was more creature comfort than most Puerto Ricans were experiencing.
“It’s like a war zone,” said RN Susan Gillispie, a former army medic who works at an urgent care facility in Beaverton. “We have people with homes totally destroyed, living under tarps.”
Union medical volunteers divided up into eight teams of as many as a dozen, each headed by a doctor, nurse practitioner, or physician assistant. Each day, each team would travel to an area in need, in vans loaded with supplies. Arriving at their destination, they’d set up pop-up clinics or split up and go door to door doing “welfare checks,” sometimes with the aid of local volunteers as translators. Each would see as many as 20 patients a day, dispensing medicine or changing dressings, referring the worst cases to doctors, or helping them get admitted to hospitals. Often, they encountered medically fragile individuals who had exhausted their supplies of oxygen, insulin, or other life-sustaining drugs.
They also educated those they met about how to treat water to make it safe for drinking.
Seeing the need, nurses used their own funds, and personal appeals on their Facebook networks, to buy and distribute supplies including medicine, food, and hand sanitizer.
Sometimes they’d be met by local community leaders. But seldom did they come in contact with other rescue workers. In fact, residents often told them they were the first help to arrive — two or three weeks after the storm.
“What’s being said about Puerto Rico doing just fine is not true,” says Tammie Tally-Ingrao, a registered nurse who works at Kaiser Sunnybrook Medical Office. “People need to know what’s going on so it does not get forgotten in December when people are still in the dark in Puerto Rico.”
All over the island, OFNHP volunteers described traveling on roads strewn with downed trees, utility poles, and power lines. They saw houses without windows or roofs. Outside the houses there would be piles of ruined furniture and belongings. Inside the houses, walls and furnishings would be covered in black mold. [Moist conditions and tropical heat are ideal for mold, especially when cleanup is made more difficult by the lack of running water.]
Different areas were damaged in different ways. In Humacao, on the southeastern side of the island, Tally-Ingrao said more roofs were blown off. In the north around San Juan, most of the damage was caused by flooding. In the mountainous interior, houses of concrete construction remained standing, but community water sources were badly damaged.
Misty Richards, a registered nurse at Kaiser Sunnyside Medical Center, says her team visited one of the most damaged areas, Barrio Ingenio, half an hour west of San Juan. Barrio Ingenio was flooded when the government opened five gates of the La Plata Lake Dam to prevent it from collapsing from the weight of Maria’s rains.
“These people, their homes are unlivable, but people are living there anyway, because what else can you do?” Richards said.
What disturbed volunteers most was that people didn’t seem to be getting the help they need. The response of the Federal Emergency Management Administration (FEMA) was at times laughable, or worse.
Nowhere did they see FEMA distributing supplies, but they did see FEMA fliers posted here and there, exhorting disaster victims to contact the agency by phone or online — on an island largely without phone service or electricity.
FEMA did set up intake stations to help disaster victims fill out a 14-page application for assistance. Tally-Ingrao said her team came upon one such center — set up in a parking lot in the town of Rio Grande. There they saw hundreds of people standing in line in the tropic heat, some for up to six hours. Several passed out from dehydration; FEMA wasn’t providing food or water. They also met and helped a woman who had dislocated her shoulder two weeks before and had no medical care since then.
AFL-CIO volunteers are now clearing out of the sports complex and returning home as of Oct. 18. But the need continues. Witnessing the things she did, Richards said she feels an obligation to shout from the rooftops that no, everything is not fine.
Nurses saw outbreaks of scabies and pinkeye while they were on the island. But worse may be still to come: With 1.8 million residents still drinking untreated water a month after the storm, waterborne illnesses could break out. Without electricity to power pumps, standing water will remain, breeding mosquitos. And continued difficulty accessing medicine will put others at risk.
“This is a health care crisis that did not need to happen,” Richards said. “It’s a man-made disaster. Maria came and went, but our government is making the situation worse by not putting enough resources into it.…This is a token effort. It’s like a kid who hands in a D-minus paper just so he can tell his parents he tried.”