Puerto Rico’s dialysis patients in trouble

This 18 April 2018 video is called Puerto Rican patients must travel 12 hours for dialysis.

By Carmen Heredia Rodriguez, Kaiser Health News:

Puerto Rico’s Slow-Going Recovery Means New Hardship For Dialysis Patients

Sunday, April 22, 2018

VIEQUES, Puerto Rico — As the cry of a rooster heralded the dawn, Joe Garcia, 41, pulled a vial of insulin from the fridge. He filled a syringe and wrapped it in aluminum foil in preparation for the long day ahead.

“I tell him that from here to there, that’ll spoil”, said his mother, Martina Collazo de Jesus, 63, watching the preparations under the fluorescent bulb lighting the family kitchen.

It is a gamble Garcia, who has both diabetes and kidney failure, has taken since Hurricane Maria slammed this Puerto Rican island just east of the main island. More than six months after the storm, Garcia and 13 other Vieques residents must still board a plane three days a week for kidney dialysis on Puerto Rico’s main island.

Hurricane Maria totaled Vieques’ hospital, which housed the island’s only dialysis clinic.

That set off an ongoing crisis for patients with kidney failure such as Garcia — who cannot survive without dialysis and for whom the thrice-weekly round trip to a dialysis center in Humacao on Puerto Rico’s main island, including treatment, takes at least 12 hours.

When seriously ill patients like Garcia will again be able to access their lifesaving treatments in Vieques remains uncertain, as federal, local officials and nonprofit groups debate strategy and finances. No one knows when the hospital will be rebuilt, either. And the government and nonprofit organizations continue to punt the responsibility of paying for the flights.


Puerto Rico, no electricity seven months after Hurricane Maria

This 18 April 2018 video is called Puerto Rico is on a blackout as we speak. We are in an island wide mayor blackout.

Translated from Dutch NOS TV:

Puerto Rico, with 3 million inhabitants, without electricity

Today, 18:20

Due to a major power outage in Puerto Rico, more than three million people are without electricity. Due to a still unknown cause, the power on the entire island has fallen out. It is expected that it will take 24 to 36 hours until the problem is resolved.

Last week, 800,000 people did not have electricity either after a branch fell on a wire.

Since the island was hit by hurricane Maria seven months ago, the electricity grid is unstable. Also then the power failed on the entire island. Since then, around 40,000 people are still not connected to the electricity grid.

Little compassion

The nearly 3.5 million Puerto Ricans are citizens of the United States, but the island is not an American state and its inhabitants are not allowed to participate in the presidential and congressional elections.

President Trump showed little compassion after the devastating hurricane. He pointed particularly to the large debt that the island has within the USA.

THE LIGHTS WENT OUT IN PUERTO RICO The island was plunged into darkness after losing power entirely yesterday, in what’s being called the second-largest blackout in history. [HuffPost]

THIS ISN’T THE LAST OF THE PUERTO RICO BLACKOUTS And the start of the next hurricane season in June looms. [HuffPost]

Puerto Rico, still no water, electricity

93-year-old World War II veteran Antonio Morales rests in a single-story concrete home with no running water, in Corozal, Puerto Rico. Morales is one of thousands still waiting for water and power as the six-month anniversary of Hurricane Maria approaches

This photo shows 93-year-old World War II veteran Antonio Morales resting in a single-story concrete home with no running water, in Corozal, Puerto Rico. Morales is one of thousands still waiting for water and power as the six-month anniversary of Hurricane Maria approaches.

From daily The Morning Star in Britain:

Saturday, March 17, 2018

Puerto Rico: Half a year on from Hurricane Maria, many Puerto Ricans lack running water and electricity

Maria approaches

PUERTO RICANS marked six months today since the formation of Hurricane Maria, which devastated the island, causing about $100 billion (£72bn) in damage.

Half a year on, many residents of the US colony are still without running water or electricity.

Only a fraction of the $23bn (£16bn) set aside by the United States Congress has actually been spent in Puerto Rico and leaders on the island denounced the sum itself as woefully inadequate. About $1.27bn (£910 million) has been received for food and just $430m (£308m) to repair infrastructure.

A $4.7bn (£3.4bn) loan approved last year for the US states of Texas and Florida and the colonies of the US Virgin Islands and Puerto Rico was reduced by the Treasury Department last month to $2bn for Puerto Rico alone, none of which has been given out.

And programmes funded by $6bn (£4.3bn) of Federal Emergency Management Agency (Fema) money have yet to reach thousands of Puerto Ricans, many of whom live in desperate conditions.

Tens of thousands of residents are still waiting for permanent shelter, water or power as the next Atlantic hurricane season approaches.

Puerto Rican officials have said that the US government is neglecting the colony, while Washington has blamed the island’s people themselves for delays in funding, although it has not been specific.

Maria destroyed 75,000 homes and damaged 300,000 more, causing an estimated $31bn (£22bn) in damage to housing alone, said Puerto Rican Housing Secretary Fernando Gil.

“If we had power in Congress … I ask myself if any federal agency would treat us as second-class citizens”, Mr Gil said. “They are not doing this to Texas. They are not doing this to Florida.”

Meanwhile, the island remains mired in roughly $75bn (£54bn) of debt, half of which is interest and almost all of which is owned by giant “vulture” hedge funds that specialise in wringing money out of poor countries and municipalities to line the pockets of their wealthy investors.

Former US president Barack Obama forced a set of punishing austerity measures on the island and the devastation left by Maria has boosted disaster capitalists who insist on privatising the struggling publicly owned electricity utility Prepa.

Puerto Rican independence leader Oscar Lopez Rivera recently condemned Washington for carrying out “perhaps the biggest experiment in neoliberalism” in Puerto Rico, “especially with privatisation. Everything is privatised — airports, trains, water.”

New report highlights Trump’s indifference toward Puerto Rico following Hurricane Maria: here.

Puerto Rico, post-Maria mental health crisis

This video from the USA says about itself:

Puerto Rico’s mental health crisis is an American disaster

19 December 2017

Around 1 in 4 people affected by a wind- or water-based environmental disaster develops a diagnosable mental disorder. Three months after Hurricane Maria devastated Puerto Rico, the U.S. territory is still struggling to recover. As the island works to restore its infrastructure, disaster and mental health experts show growing concerns over a burgeoning mental health crisis. Click play to learn about how “natural disasters” affect the mind.

By Ali Abu Elhassan:

Mental health crisis descends on Puerto Rico’s working class

9 March 2018

As the six-month anniversary of Hurricane María approaches, a deadly mental health crisis has emerged on the island of Puerto Rico. Health officials are reporting endemic levels of trauma related emotional disorders. Many Puerto Ricans are showing symptoms of post-traumatic stress disorder (PTSD), experiencing extreme anxiety and depression for the first time in their lives. The severity of the crisis is most sharply expressed in the rise in suicides, which has seen a disturbing 30 percent spike since the storm made landfall.

The reports of PTSD are a testament to the reality of life for the working class in Puerto Rico as the disorder is most popularly associated with soldiers who experience trauma in war zones. The sudden and long-term loss of access to basic necessities of life such as running water and electricity, homes left destroyed and roofless with residents still occupying the structures, the covering up of a massive death toll, the destruction of public utilities, school buildings, education and jobs, as well as an increase in policing has had a traumatic impact on the island’s population.

Thousands of people with preexisting mental health problems have been unable to obtain their needed medications and therapy, causing marked deteriorations in their conditions, especially among the elderly who are particularly vulnerable. Storms and rain produce anxiety and paranoia in children and adults who become worried that there will be more flooding.

Symptoms of PTSD include irritability, mood swings, anxiety, depression, repeated and vivid memories of the event, which lead to physical reactions, confusion or difficulty making decisions, sleep or eating disorders, fear of the event being repeated, an increase in conflict or a more withdrawn and avoidant personality, and physical symptoms such as headaches, nausea, and chest pain. These responses can vary widely depending on the individual, the environment, and the event.

The only suicide hotline in Puerto Rico, Linea PAS, has been dealing with a surge in calls, up nearly 70 percent, from people contemplating suicide.

In an interview with Univision Noticias, the director of Linea PAS, Monserrate Allende Santos, relayed that between the months of October and December 2017 the program received 9,000 suicidal phone calls; 6,733 calls were from callers with suicidal thoughts, while 2,206 were from people who had actually attempted suicide.

A member of the hotline’s call-taking staff told the New York Times, “Sometimes I cannot find the words. Because how can I tell someone to keep calm when they don’t have a place to sleep.”

Linea PAS’ staff, many of whom have experienced their own hardships, patiently try to console, reassure, and talk suicidal hurricane survivors who have lost all hope out of ending their lives. Another staff member is heard in a Times video telling a caller, “the situation of not having light in your house, the situation of being dark, of not having resources, this is temporary.” For some, however, it is not certain that this assertion is true.

In an interview with Newsweek, Kenira Thompson, who heads mental health services at the Ponce Health Sciences University, stated that for the people in rural areas, “It’s as if the storm hit last week.”

Mental health issues will not stop”m Thompson explained, “if you think about the next hurricane season will start again [soon]. We will have chaos when the first storm is announced on the news. Hopefully, it’s not another storm like María.”

When María made landfall on the island in September, it descended upon a population already in the grip of extreme poverty and depressed living standards. Having been in recession since 2006, half the population stood below the official poverty rate while the official unemployment rate stood at 16 percent. A staggering 60 percent of eligible workers did not participate in the labor force, instead relying on food stamps or working in the “underground economy.”

In the wake of the hurricane this already precarious situation dramatically worsened. Hundreds of people perished or died in the aftermath from lack of basic necessities. Hundreds of thousands of homes and basic infrastructure have been destroyed, leaving, to this day, 150,000 homes and businesses without electricity and much of the island in ruin.

While it’s common for people to experience stress in the immediate aftermath of such an event, the American Psychological Association (APA) stresses that recovery is dependent on one’s ability to resume functioning as they did prior to the disaster and to engage in healthy behaviors, such as a healthy diet, establishing routines, and seeking getting help from a licensed mental health professional.

Healthy behaviors cannot develop when countless homes remain destroyed, when people are trying to live without roofs or are forced to join relatives in overcrowded, unsafe conditions. The establishment of routines is not a possibility in circumstances where people are chronically living without electricity, are struggling to find food and clean water and are unable to travel on closed roads to frequent, or work, in closed businesses and attend closed schools.

The Federal Emergency Management Agency has provided a paltry $3 million for the mental health division of the Puerto Rican Health Department. The failures and crimes of FEMA, and the US government more generally, against the working class of Puerto Rico are innumerable.

In the immediate aftermath of the storm, ports that import about 85 percent of the island’s food supply were shut down under the draconian hundred-year-old Jones Act, which the government only reluctantly lifted weeks later. Another outrageous episode was when Tribute Contracting LLC, awarded a $156 million contract to deliver 30 million meals, only managed to deliver 50,000. The criminality of the US government is best exemplified, however, by the efforts to undermine and ultimately privatize the island’s resources and infrastructure, currently the education system and the public electric power company.

This inadequate provision of social and psychological services by the government has compelled universities to send teams of students, social workers and other volunteers out in a piecemeal effort to meet the needs of the population. These students and workers have made their way to the worst hit areas inland, which have become isolated and hard to reach due to the poor recovery efforts. They go door to door and visit emergency shelters where the newly homeless are crowded in order to conduct physical and psychological screenings and deliver food and water.

Observers and health experts have drawn parallels between the aftermaths of hurricanes Katrina and María: From the physical and social devastation they visited upon New Orleans and Puerto Rico, respectively, to the inadequate governmental response marked by gross negligence and arrogance, the long term physical and psychological trauma their victims are suffering, and the fact that these are both climate-change related catastrophes.

In a report published last year titled, “Mental Health and Our Changing Climate: Impacts, Implications, and Guidance”, psychologists with the APA found that 12 years after Hurricane Katrina, survivors developed mood disorders, saw rates of suicide and suicidal thoughts double, and one in six met the diagnostic criteria for PTSD. Psychiatrists have since stressed the importance of immediate access to mental health care for the victims of natural disasters to help mitigate these types of outbreaks.

At the 10-year mark of Hurricane Katrina, the WSWS published an analysis of the source of the catastrophe that is no less apt at describing the one facing Puerto Rico today: “The sudden shock of Hurricane Katrina exposed the rot at the heart of American capitalism. Decades of social neglect, the staggering growth of social inequality, the putrefaction of American democracy, and the domination of every facet of social life by a narrow and parasitic layer of financial speculators was laid bare before a shocked American and world public. For millions of people around the world, already horrified by American imperialism’s criminal adventure in Iraq, Katrina demonstrated that the American ruling class was no less hostile towards its own working class.

“This rot has spread geometrically in the years since then. Since the onset of the 2008 recession, the attitude of the ruling elite towards Katrina, which saw it as an opportunity to open up further opportunities for profit, has been replicated in every facet of American life. Instead of responding to the recession with a public works program or other measures to alleviate the distress of the working class, American, and, indeed, world capitalism … has responded with a fundamental restructuring of class relations, aimed at nothing less than the dismantling of every gain made by the working class in over a century of bitter struggle.”