Weathering the Storm

Weathering the storm was a terrifying and traumatic experience for participants. Some participants made preparations for the storm, while others anticipated the storm would pass by the island or not be as strong as predicted. Many stayed in their home to weather the storm and brought family and friends to stay with them. Others went to stay with family or friends who had sturdier homes. Participants described the frightening strength of the storm winds and significant rain and flooding. They said that the storm felt endless and they worried about the well-being of family members they were separated from during the storm.

“I didn’t believe it would get here. I mean, I thought it was coming but not with so much strength.”

“We got ready to go. Water, emergency provisions for home, tins, non-perishable goods. Also, I have a plastic container, which we call ‘Hurricane,’ in which we keep torches, candles, anything you may need.”

“I told my wife and my children to go with mom since that house is…made of cement all around.”

“I was holding a door for two hours so it wouldn’t get blown away… ! So, we did that until we came up with putting the sofa as a wedge…And the sofa even moved with the wind….but that was the best thing we could have done…. But that…is something I don´t want to go through again…”

“My mother has several conditions and she takes between 12-14 drugs, and that triggered a bit of anxiety in me…. That was my biggest concern, and so I stocked up on them before the hurricane came.”

“There was a moment when the wind stopped. And then it came on the other side… Later, when night had fallen, I could only see upwards and all the destruction and wondered ‘What could we do now. How can I start?'”

“I thought there was no end to it. We stood by the window, watching what was happening to my house. The wind and the rain wouldn’t stop, there were things flying, the trees falling. It was endless.”

“….we were really worried, wanted to know how they were and there were zero communications. It was quite desperate…during the hurricane it was terrible to think about our grandparents, which is the closest family we have.”

Immediate Aftermath of the Storm

Participants struggled to meet basic needs immediately following the storm. Many participants suffered significant damage to their homes and properties, with some losing everything. They said that in the immediate days and weeks following the storm, it was extremely difficult to meet basic needs and that lines, for water, food, gas, and money were up to 8-10 hours long. In the weeks following the storm, there were no communications on the island and travel around the island was difficult, making it challenging to check on the well-being of family and friends. Few received any aid in the days and weeks immediately following the storm. One silver lining several participants highlighted, was that the storm contributed to increased community and stronger relationships with their neighbors as they worked together following the storm.

“I saw the entire process of what happened to my house. It was a total loss. It exploded. A 100 year old mahogany tree fell on it and everything was gone… My dad was in tears out of helplessness in the face of that situation.”

“…it seemed someone had set a shower in my house, the whole house was leaking water.”

“We divided the tasks at home: my brothers went for fuel, I cooked, grandma helped me with the kids. Mom and my husband tidied up.….We knew that if we all went for fuel, we’d never finish what needed to be done at home. I waited in line 6 or 8 times for $10 worth of fuel. One of them took 6 hours, and in the end, it was only $10!”

“You’d stand in a huge line and when you arrived at the counter they’d tell you that you could only take two gallons per family. And then you’d think, well, at home we are five and we drink three gallons in just one day.”

“There was no way to communicate. You couldn’t drive, there were too many things blocking the roads, and there was no internet, no cell-phones…”

“The municipality came by my house with water and a bag of food about three weeks ago. But that was not long ago. In those first weeks, there was no help.”

“We have come closer together as a family and also with the neighbors.”

Effects on Physical and Mental Health

Participants said that access to health care was limited and chaotic immediately after the storm with limited staff, hospitals without power, injuries and deaths. They noted that pharmacies were unable to process insurance without power, so some had to pay out of pocket for medications. Some pharmacies provided medications on credit and /or without a prescription to help ensure continued access to medications. Participants noted that the ability to access health care has improved over time, but challenges persist, including longer waits, transportation challenges, and limited hospitals, clinics, and pharmacies, with many still running on inconsistent generator power. A number of participants had health coverage through Reforma, Puerto Rico’s Medicaid program, and said the coverage is key for accessing needed care for themselves and their children.

“I was worried about the baby, because of the bilirubin levels, and there was no sun. So I took her to the emergency and they kept her for 24 hours….in the same area where they brought the dead.”

“The pharmacy at the hospital had run out of many things after a month. It’s not that the pharmacy doesn’t want to sell it to us, it’s just not available.”

“You can get an appointment, but not as easily and frequently. What the physician does is give them prescriptions for a whole month. So we go and see him every month or month and a half.”

A number of participants said that the storm disrupted their access to medications and treatment. For example, several participants said they did not have access to insulin because they had no ability to refrigerate it, and one participant was unable to obtain dialysis treatment due to lack of power. Participants said it has been harder to manage chronic conditions like asthma, high blood pressure, and diabetes due to stress and anxiety, limited access to medication, and increased consumption of processed and canned foods and soda due to difficulties accessing fresh food.

“I ran out of insulin. I was told to put in tepid water in a glass. But I saw that the insulin wasn’t translucent, it had sort of crystallized, like sugar.”

“For my grandmother’s diabetes, the diet change has been terrible. It’s completely out of control. As there is no electricity, we cannot eat the same food.”

Participants also described profound effects on their mental and emotional health. They noted that while they try to be strong for their children and others, they feel desperation in moments alone. Many said they feel stressed and anxious and are having trouble sleeping at night. They also said that many of their children are fearful and frightened ever time it rains. Several were also affected by deaths they witnessed or knew of as a result of the storm.

“What I’ve seen around me is death. People who have committed suicide. After the hurricane, they have been in very sad situations, really.”

“The place where I felt okay was the bathroom. If I had to cry, I cried. And sometimes I tried to muffle my sobs with the bath curtain.”

“My husband goes hysterical. When he comes home from work he starts digging, with the flashlight, and tries to rebuild the porch. He hates the night, doesn’t sleep.”

“One of my grandchildren, whenever there’s heavy rain, she asks me to close the windows and get into the bathroom with her. I tell her to be calm, but she cannot.”

Life Two Months After the Storm

Daily life remains very difficult and disrupted two months after the storm. Participants said some basic needs still have not been addressed. Most are still without power, and where power has returned, it remains unpredictable. They also pointed to continued challenges accessing water and gas and noted that cell service and communication remains limited across the island. Participants described the struggles of daily life without power, noting that they are unable to keep fresh food, unable to cook inside their home, and or to use their washing machine. They emphasized that there is no relief from the heat and mosquitos and constant noise and air pollution from generators. They also said that there remain significant traffic jams and delays on the roads due to the lack of traffic lights.

“…we miss the comfort of things we used to take for granted. Like, we used to get up and we’d be able to take a shower, it was as simple as putting the clothes in the washing machine, and leaving…To have the comfort of cooking inside the house…”

“Even now I don’t have a signal at home. I have to go out on the highway. You can’t communicate. And things are very difficult.”

“To date, I am still in survival mode.”

“But now with my dad, I have to wake up much earlier. I had to bring them home with me, as they have no power or water since Irma. He’s diabetic and has conditions so I have to wake up a lot earlier and I have to medicate and take him home, then take the girls to school and get to work.”

Participants’ daily routines remain disrupted. Some participants are still displaced from their homes or have displaced family or friends living with them. Some children returned to school, but many schools are operating under shortened schedules. Some participants have returned to work, but a number went many days without work or lost their jobs. They noted that many jobs are not available right now because of the lack of power. Moreover, it is more difficult for parents to work given the more limited school hours.

“It has changed completely. We live in one space….Seeing those elderly people get up…and they were used to sitting on the balcony. Today, you find them crying because they cannot do it. It affects me. I adapt, but it affects me.”

“I’ve already relocated. I looked for a place to rent because my house must be reconstructed completely.”

“I found work last week. Prior to that I didn’t have a job, ever since Irma. I was a bartender but lost my job. Because my workplace was left without power and couldn’t operate.”

“…I was not working for so long, because I used to work at schools and, if they are not open, I don’t work. And that triggered a lot of anxiety…. Because…I used to be the one who made money. So although I tried to channel all those energies, I did get a bit hopeless.”

Views on Recovery Efforts

Participants feel that recovery efforts have been slow and that major gaps in basic needs remain two months after the storm. They did not feel that President Trump has provided much help or respect for the people of Puerto Rico. They said that assistance from FEMA has been slow and not well targeted. Some felt that FEMA is acting slow because FEMA funds were misused by some individuals after previous storm. In addition, many thought that local government is complicating and slowing down recovery efforts.

“…after two months, there are people who still can’t be reached because there is no road, they cannot leave their homes. They can’t get food. And you think, my God…but there is so much arriving!”

“And when he [President Trump] did his crazy things, throwing paper towels, he wasn’t valuing what we were going through, our pain.”

“They are taking so, so long, that I wonder, how is it possible that people who lost their homes aren´t given priority.”

“But they also have to think of the emergency we are in, they [FEMA] can’t take 60 days to assess a house, when it is obvious the assistance is needed.”

“The thing is, FEMA can’t do anything until the municipality and the state agree on something and they start moving.”

“I think FEMA is acting in a responsible way, being very cautious and studying properly every case. Because…in the other incidents, people would take the money and wouldn’t fix their homes. ”

“I’d have to call [FEMA] three times on the same day and they’d give me different versions of the information. So, I’d have to take note of their names and the version they had given me. And this situation is like walking uphill, because these new employees don’t know what to tell you about the assistance…”

Thoughts on the Future

Participants believe the island will recover, but that it will take a long time, likely many years. They feel there remains great needs across the island, but that there is not enough recognition of the continued need and suffering. Many noted that they remain committed to staying on the island and recovery, even though staying is hard. Others are leaving because they are no longer able to find employment to support them. Many have family and friends that have already left the island. Participants want more transparency and information about recovery efforts, in particular, about where funding and supplies are going. They also believe that the people of Puerto Rico have a role to play in recovery themselves, and that they can’t just sit back and wait for assistance.

“I’d like to stay where I am, but it depends on the power and work. For the moment, I’m staying.”

“I have friends who have little children and left because the children couldn’t get used to not having electricity or water.”

“I’m looking for a job, and I’m analyzing other options I have, like starting my own business… but I have to do something.”

“It will be good. It will be slow, but it will be good.”

“I have faith in that it will get better. That the storm took some things, but it didn’t take our warrior hearts.”

“I would like Puerto Ricans on the outside and Americans to know there are brave people here, strong, and they are not giving up, because we are fighters.”

“I also think that it is not like we are just sitting here waiting for help to move. Because we are moving. But there comes a limit where you get stuck because you don’t have more resources.”

“We ourselves. Puerto Rico helping out Puerto Rico.”

Conclusion

These findings show that Hurricane Maria was a terrifying and traumatic event for many Puerto Ricans. Many suffered significant damage to their homes and property, with some losing everything, and many are struggling with mental and emotional effects of the storm and their losses. Two months after the storm, individuals were continuing to face challenges meeting basic needs, and daily life remained extremely challenging, due to lack of electricity and limited work options. Individuals feel that recovery efforts have been slow and insufficient and emphasized that the island still needs substantial help and resources to recover. Despite these challenges, many believe Puerto Rico will recover, although they recognize recovery will likely take many years and believe that the people themselves have an important role to play in recovery.

The authors extend their deep appreciation to the individuals who shared their time and stories as well as the individuals who helped make this project possible including, Perry Undem Research/Communication and Marisol Lugo Juan with Lighthouse Market Intelligence.

Introduction Appendix

KFF Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KFF | twitter.com/kff

The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.