Emergency Response to Hurricane Irma and Maria

On September 20, 2017, Hurricane Maria struck Puerto Rico with a deadly force and crippled infrastructure. While it took nearly a full year to restore power to all parts of the island, residents in the rural areas continue to have challenges accessing vital services. Puerto Rico’s mountainous terrain can make traveling long distances difficult. As the island sought to recover economically and rebuild stronger, telehealth emerged as a tool for improving healthcare delivery in these rural areas and for improving the integration and digitization of health information.

So far in 2020, Puerto Rico has been navigating earthquakes, the COVID-19 pandemic and preparing for what is predicted to be yet another strong hurricane season.

Telehealth has been a key innovation to control the transmission of COVID-19 and reduce barriers to health during all of these concurrent disasters.

Hospital Perea in Mayaguez is a small facility with 118 beds that serves the historic town center of the third most populous municipality in Puerto Rico. Mayaguez was one of the first municipalities to see COVID-19 cases.

Marisol, Head Nurse at the Intensive Care Unit (ICU) at Hospital Perea, used her personal cellphone to help isolated COVID-19 patients video chat with their families and discuss patient care plans with their close family members. However, as the hospital increased its infection prevention and control measures and the danger of COVID-19 grew, she was no longer able to bring her phone in and out of rooms with infected patients. Other staff members were struggling with similar concerns, like the hospital social worker who had also been contacting families through the video capabilities on her phone.

After hearing Marisol’s concerns, International Medical Corps provided 20 tablets to Hospital Perea to help improve infection prevention and control measures. Because dedicated tablets remain in the hospital’s ICU where they are used by healthcare professionals in personal protective equipment (PPE) and are not being brought into the homes of healthy hospital staff members, there is a reduced risk of spreading the virus.

The tablets have increased Hospital Perea’s telehealth capacity not only for the ongoing COVID-19 pandemic but for future emergencies. The hospital uses the tablets across various departments to:

• connect isolated patients with their friends and families
• enhance the hospital’s health information technology
• provide health guidance to patients
• train staff on donning and doffing PPE, and more.

The ICU received five tablets which are used daily with patients hospitalized with COVID-19 or other serious conditions. Because the ICU does not allow any outside visitors, these tablets are the primary link patients have with their families. Marisol observed that when the patients are communicating with their families, their stress levels reduce substantially. She can visibly see improvement on heart and blood pressure monitors during these conversations.

With the support of the GlobalGiving community, International Medical Corps continues to help build capacity and resiliency across Puerto Rico.

“During this difficult time worldwide,” says Coralys, our Mental Health and Psychosocial Support Coordinator in Puerto Rico, “our team has developed new and innovative strategies to address the most pressing needs related to mental health and, more specifically, suicide prevention.”

One of those innovative strategies is a new series of webinars which adapt training to the physical distancing requirements of the COVID-19 pandemic. With generous support from GlobalGiving, these webinars provide culturally responsive information about suicide prevention, including risk factors, stress management and crisis intervention strategies. The webinars also aim to reduce the stigma associated with mental health challenges and to combat myths and misinformation.

International Medical Corps’ webinar series has already reached 142 community members, 26 mental health patients and 165 health workers. Following one of the webinars, one of our participants stated, “it is so relieving to know that I can now do something when a friend or family member is contemplating suicide.”

While the intention behind the series is to ensure continuity of services, Coralys considers the greatest challenge to be, “reaching the two most vulnerable populations during quarantine, older adults and walk-in emergency patients who were affected by the initial lockdown of health facilities.” Our team partnered with local churches and other religious organizations to reach older adults, and the webinars helped staff at the walk-in clinics provide patients with the skills they need to address their emotions and prevent crises such as suicide.

Coralys explains that, “By working collaboratively, we have identified needs, provided guidance, and referrals to participants to current available mental health services” – and helped to save precious lives.

We thank the GlobalGiving community for continuing to support mental health and psychosocial support in Puerto Rico.