Keeping Facilities Open: Stabilizing and Restoring Puerto Rico’s Health Sector Following the Island’s Worst Hurricane Season Ever

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Keeping Facilities Open: Stabilizing and Restoring Puerto Rico’s Health Sector Following the Island’s Worst Hurricane Season Ever

Author: Laura Wolf and Steve Curren, Division of Resilience, Office of Emergency Management, Office of the Assistant Secretary for Preparedness and Response, HHS
Published Date: 12/14/2017 10:38:00 AM
Category: Response & Recovery;

In the aftermath of Hurricane Maria, the Department of Health and Human Services (HHS) immediately deployed thousands of staff members and health care providers to Puerto Rico. Almost daily, the national media highlighted work HHS Disaster Medical Assistance Teams did to save lives. Less known are the activities and programs HHS put in place that went beyond direct patient care. Hundreds of personnel, from logistics experts to security personnel, worked behind the scenes to help restore Puerto Rico’s health sector. Their mission: to assist local hospitals, dialysis facilities, clinics, and medical supply manufacturers in obtaining the resources needed to continue or restore operations. These businesses are the backbone of the local economy and, even more importantly, are essential in saving lives.

Within days after Maria’s landfall, HHS and other response partners began conducting site visits to healthcare facilities across the island to identify their capabilities after the storm and determine what they needed to provide patient care. Did hospitals and dialysis centers have supplies and equipment their patients would need? Did the facilities have generators, and if so, how long could those generators run? Did laboratory equipment survive the storm? Did the facilities have diesel to run those generators? Did medical suppliers, such as oxygen manufacturers, have the resources they needed to continue production and delivery? Did pharmaceutical companies – a major employer in the territory and critical to the rest of the U.S. – have power and necessary resources, such as industrial gases to continue the production of critical healthcare products?

One of the most immediate needs across the health sector was power restoration. HHS worked with the Federal Emergency Management Agency, the Department of Energy, and the Army Corps of Engineers to communicate the importance of assisting hospitals, other healthcare facilities, and medical manufacturers and distributors with power restoration, generators, and generator fuel.

HHS identified medical and industrial gas production as another priority need for the health sector in Puerto Rico. Hospitals, home healthcare providers and pharmaceutical companies require medical oxygen as well as other gases to support patient care and healthcare product manufacturing. Due to the challenges of shipping gases long distances, Puerto Rico usually receives all its medical gases from two manufacturers on the island, Both of these manufacturers lost power in the immediate aftermath of Hurricane Maria, threatening the supply of gases for healthcare and creating the potential for a serious risk to public health. HHS quickly convened a task force composed of representatives of the two impacted manufacturers and other federal response partners in order to identify solutions to the gas supply disruption. This task force developed a system for shipping large containers of liquid oxygen and liquid nitrogen to Puerto Rico from the Continental United States. The federal members of the task force assisted the companies with regulatory and permitting issues as well as prioritization of on- and off-loading of cargo vessels.

Sodium chloride, also known as saline, also ended up in short supply due to disruptions to a critical manufacturing facility in Puerto Rico. This shortage impacted not only the healthcare system in Puerto Rico, but hospitals and other healthcare providers across the Continental United States who rely on the saline produced on the island. HHS assisted the impacted company with transportation and other needs in order to facilitate the movement of product off the island and held calls with healthcare system partners to discuss strategies they could implement to help conserve and replenish this essential medical supply.

Diesel fuel for generators became another priority to help stabilize the health infrastructure. HHS staff learned that diesel trucks were not reaching their destinations. The staff immediately reached out to the appropriate federal agencies to arrange for law enforcement escorts to ensure diesel got where it was supposed to go.

HHS also held daily teleconferences with hospitals, healthcare suppliers, and pharmaceutical companies to understand the impacts of the storm and to provide the latest federal information on response activities. In addition, we worked with the National Volunteer Organizations Active in Disasters and its partner Healthcare Ready. These organizations processed and distributed donations to help strengthen healthcare supply chains.

While having the right size generator is a basic preparedness step for many businesses in the health sector, one of the lessons emerging from this year’s hurricane seasons is that generators typically are built to run for a week or two not long-term, and they require regular maintenance. Private physicians’ offices, too, need to talk with their building owners about whether the building has a generator maintained regularly and of suitable size to allow the offices to remain open in long-term power outages.

Recovery is a marathon, not a sprint. Immediate after the storm, our goal was to help health care organizations jumpstart the process by helping the health sector obtain the resources they needed to get or keep their facilities running. The health sector continues to work toward full recovery, and HHS will be there to help every step of the way.