To say that Hurricane María caused catastrophic damage to Puerto Rico is an understatement. When evacuation orders were announced before María made landfall, officials opened 450 shelters on September 18, and by September 19, 2000 had entered them. People also left the island beforehand, and a reported 20% increase in travel away from the island occurred the day before the hurricane struck the island. Unfortunately, Hurricane Irma had already struck two weeks before María, and 80,000 residents still had no power on the recovering island. By the time María passed through Puerto Rico, it ravaged the island with winds sustained at 155mph. The Category 4 hurricane was the most intense Puerto Rico had experienced since San Felipe Segundo struck in 1928.
Unfortunately, recovery on the island has been exceedingly slow, and complicated by official death counts which have varied widely. The first official number of dead issued soon after the hurricane was 64. But, as time has passed, more and more deaths have been attributed to the hurricane. Part of the disparity among numbers reported is that deaths which were considered indirectly related to the hurricane were not included in the original total. But officials have begun to realize that hurricanes can cause illness and death long after the initial strike.
On December 9, 2017, Telemundo reported that Department of Public Security Secretary Hector M. Pesquera certified the two deaths which brought the official total in Puerto Rico to 64. The article noted that one death occurred the day of the hurricane but was not reported has hurricane related because the doctor certified the death as natural on the death certificate. This is just one case which has spurred research to determine just how many deaths were not initially reported but should have been. These indirect deaths are the cause of certain ongoing misery on the island as numbers continue to rise.
It’s been just a bit beyond six months ago when Hurricane María struck. Since that time, Alexis Raúl Santos, Director of the Graduate Program in Applied Demography at Penn State, has initiated a project studying how Hurricane María has affected Puerto Rico. He has conducted an online survey of Puerto Rican Diaspora to discover how families are dealing with conditions resulting from the hurricane. He has also studied the number of deaths reported compared to historical patterns for deaths in the years from 2010 until the hurricane. He’s gathered extensive information and compiled his demographic results into language which the public can use to consider what has happened in Puerto Rico and what should be done in the future.
Santos has research which shows that 1,085 more people died in Puerto Rico as a result of the hurricane than was originally reported. Officials followed various protocols and simply didn’t count deaths which were not due to the hurricane’s initial impact. But, there were deaths that followed quickly afterward. Most notable are the 47% increase in deaths related to sepsis, the 45% increase in nursing home deaths, and the 41% increase in deaths in emergency rooms. All of these are higher than the number of deaths for the same period in 2016. Santos explained his reasoning for assessing the disaster as being the best way to effectively prevent similar deaths during future events.
Santos research is particularly relevant in view of Governor Ricardo A. Rosselló’s recent December order to review every island death since the hurricane. There is increasing evidence that the number of people who died due to hurricane-related reasons has been significantly undercounted. Three to four million people were left without electricity on September 20, and this included those in clinics, hospitals, nursing homes and homes. The blackout was extensive and vulnerable patients on respirators, dependent on dialysis, or bedridden died because they did not have the medical treatments they needed. Governor Rosselló issued a public statement which acknowledged that these people deserved to have an official accounting of their deaths.
Since the time of the announcement, mortality totals continue to be revised. Included are deaths which occurred because ambulances could not pass through debris-blocked roads quickly enough to respond with emergency care. Heart attacks which occurred due to the incredible stress related to the hurricane are being counted. The sharp spike sepsis deaths are being taken into account, as complications from this deadly infection continue to occur. Patients dependent upon CPAP machines who died are being considered for inclusion in the rising death count. The Governor is intent on an accurate accounting for every death on the island, and this is going to take time. But, it is also a significant way for the island to receive the help from the United States that it needs.
When President Trump visited the island soon after the hurricane hit, he praised Puerto Rico for surviving with such a low death count. Puerto Rican officials had followed the Centers for Disease Control and Prevention protocols for numbering deaths related to storms. But, demographer Santos reiterates that statistics will give Puerto Ricans the voice they need to get the political power necessary to secure help during environmental disasters such as this one. Puerto Rico has been a territory of the United States for generations, but its residents do not have the right to vote. Santos believes that the island is suffering from underreporting the extent of damage caused by the hurricane, and that this has caused the United States to be slow to provide disaster relief. The amount of aid has been inadequate in comparison the actual need and circumstances.
If Santos is successful in his efforts to systematically and accurately report a revised death count, Puerto Rico may be able to receive increase efforts to help its citizens as they struggle without power and adequate sources of clean drinking water. The engineering and governmental help the country needs to move past the devastation and plan for the future is now dependent upon gruesome numbers and the insistence that human dignity be respected and maintained.