Puerto Rico was already stressed with one of the poorest medical systems in the United States, but the dual blow of two major hurricanes has left this island with a medical crisis that is usually reserved for war zones.
"I haven't seen anything like this. It's really bad," Dr. Maria Rodriguez told me when I visited
her community health center, Concilio de Salud Integral de Loíza, in a small town in the northeastern portion of Puerto Rico. She was struggling to provide care for patients in her clinic due to a lack of fuel and, later, water. Medications were in short supply.
"You go to the shelters and you see people sleeping on the floor," Rodriguez told me. "The conditions, the desperation that all these people have. We are trying to still provide services to these people."
That was one week to the day after Hurricane Maria hit the island with its 155-mph winds and then dumped 30 inches of rain, flooding the island and causing unprecedented devastation.
It hasn't improved much since.
The inability to navigate debris-covered roads, combined with a lack of communication, has made it all but impossible for a coordinated medical response on the island. Hospitals and clinics are slowly opening, but still do not have enough supplies and medications to care for the surge of patients, many of whom have been waiting for medical attention for days in nearby shelters.
Just Thursday, my crew and I transported a woman with a life-threatening infection from a shelter to a local hospital. Josefina Alvarez, 62, had been waiting for medical help for a week and a half in a shelter in Loiza
, not far from San Juan, but was running out of time.
"She's getting more complicated, with fever and all that, and we have nothing here to give her," said Dr. Astrid Morales, a local physician volunteering at the shelter. "Time is really limited."
Thankfully, her husband told me she is now being stabilized and is expected to undergo surgery soon.
Yet while Alvarez went without antibiotics, the port in San Juan was filled with row after row of containers of food, water and medicine, if only doctors had access to them. Instead, those supplies are still piled up, waiting for the trucks, drivers and fuel needed for distribution.
Volunteer doctors with operational cars and adequate fuel have begun taking matters into their own hands, traveling to San Juan to obtain medical necessities and transporting them back to their local hospitals, clinics and shelters.
Just what is that like? How hard is it to get your hands on these desperately needed materials? My crew and I decide to find out.
Armed with a list of critical medications needed at the Loiza clinic, we first head to the local US Department of Health & Human Services tent to talk to the local disaster management team.
A staffer named Lisa looks over my list. "Yes, we have these medications," she tells me. She asks us to wait 15 or 20 minutes.
The crew and I settle down to wait. The staffer told us they'd have to run it up two chains of command before medications could be distributed.
Forty-five minutes later, we are still waiting. But we hear about a US-based aid organization, Direct Relief
, that has shipped $1.7 million dollars of medical supplies to San Juan.
A 10-minute drive away, we find Direct Relief staff handing out supplies to local doctors under a parking structure. The scene is controlled chaos, as each doctor tries to grab the medications they need.
I join in.
"Let me see that list," says one of the senior doctors. Before long, he's handing me the antibiotics I came for: ciprofloxacin, levaquin, azithromycin, rocephin, clindamycin and cefepime.
Minutes later we're in the car, on our way to the shelter. Rodriguez meets us in the lobby when we arrive.
"Thank you!" she beams as she looks through the bag and then hugs it to her tight, like a baby.
I hug her, thankful I could be of help.
One of my favorite professors in medical school told me something I never forgot: "You can create the best treatment in the world, but if it doesn't reach the people who need it, it has no value."
I think the same can be said about what's happening in Puerto Rico. So many lifesaving supplies are on the island, but until they get to the people who need them, they have little value.