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Lack of power in Puerto Rico creates life-or-death situations for those with medical needs

In the aftermath of Hurricane Fiona and in the fifth day without power and water, families of sick patients need generators as islanders worry about the availability of fuel and other supplies.
Homes are flooded after the passing of Hurricane Fiona in Salinas, Puerto Rico on Sept. 19, 2022.
Homes in Salinas are flooded this week after Hurricane Fiona passed through Puerto Rico.Alejandro Granadillo / AP

JAYUYA, Puerto Rico — When Hurricane Fiona completely knocked out power and water to the mountain town of Jayuya, in the heart of Puerto Rico, it quickly became a life-or-death matter for Luis De Jesús Ramos, who has throat cancer and a tracheostomy.

De Jesús Ramos is one of many Puerto Ricans for whom electricity is essential to survival, and each day without it brings an increasing sense of urgency. 

He relies on life-saving electricity for everything: from using a blender to prepare his liquid meals, a refrigerator to keep his food, an adjustable bed that keeps him in the positions he needs to be in to sleep safely, and the medical supplies required to maintain and care for his tracheostomy.

Although he can no longer speak, De Jesús Ramos, 63, a bald man with patches of white in his beard, gestured around his home on Thursday in a white T-shirt and striped flannel pajamas as he pointed out each piece of the puzzle needed to maintain his health needs.  

Image: Luis De Jesús Ramos, 63, and his daughter Ashly Perez, 26, in their home in Jayuya, Puerto Rico.
Luis De Jesús Ramos, 63, and his daughter Ashly Pérez, 26, in their home in Jayuya, Puerto Rico.Daniella Silva / NBC News

“He really needs these things. It’s an emergency,” his daughter Ashly Perez, 26, said in Spanish, speaking from the ground floor of his family’s home up a winding road in Jayuya, a region where landslides cut off roads and left bright brown mud, downed trees and split branches.

Most of the nearly 1.5 million power customers in Puerto Rico are still without electricity after an islandwide blackout was reported Sunday about an hour before Hurricane Fiona’s eye even entered the island.

As of Friday afternoon, 601,500 customers had their electricity restored, which represents roughly 41% of all customers, according to Luma Energy, the company in charge of power transmission and distribution in Puerto Rico. Most of the customers who’ve been reconnected to the grid are in the northeast, where the storm caused less damage.

As Puerto Ricans enter their fifth day without power, concerns over fuel accessibility on an island forced to rely on backup generators to power homes and even critical infrastructure such as hospitals and telecommunication towers have started to rise.

Image: Members of the company LUMA work restoring energy on Sept. 20, 2022 in San Juan, Puerto Rico.
Members of the company Luma work restoring energy Tuesday in San Juan.Jose Jimenez / Getty Images

Long lines are starting to form in gas stations. Businesses, including grocery stores and pharmacies, are also starting to close temporarily over the lack of power or fuel to operate their generators.

Government officials on the island insist there's no shortage of fuel, pointing out that there's enough supply for 60 days. Distribution challenges are to blame for recent disruptions in fuel accessibility, "which are being addressed," Puerto Rico’s Secretary of State Omar Marrero said at a news conference late Thursday morning.

Nearly 73%, or 968,793 customers, have had their water service restored as of Friday morning, according to the Water and Sewer Authority. Close to 440,000 of these customers are getting their service thanks to temporary generators energizing certain water bombs. About 360,000 customers (27%) still have no water.

Doriel Pagán-Crespo, executive president of the water authority, said the agency was continuing the work started Thursday to bring water back to sectors in the municipalities of Jayuya, Lares, Aguada, Moca, Rincón and Aguadilla, after debris from the irrigation channels moving water from Río Guajataca were cleared.

‘Without electricity, there is no health’

After learning about De Jesús Ramos’ condition, Ivonne Rodríguez-Wiewall, executive adviser of Direct Relief Puerto Rico, and a team arrived at his home in Jayuya on Thursday afternoon bringing a generator. Direct Relief is a nongovernmental organization that donates medical supplies and other relief to communities. 

De Jesús Ramos made the sign of the cross and looked up, thanking God as they set up the generator at his home.

“It’s very important to understand that health is very linked to having a source of power,” Rodríguez-Wiewall said. “Without electricity, there is no health.”

Rodríguez-Wiewall and her team handed out hygiene kits and solar lights and batteries to nearby residents. The entire area appeared to be without water and power, except for the homes where the loud humming of generators could be heard.

Five years ago, nearly 3,000 people died in the months after Hurricane Maria devastated the island, a far higher number than the government’s first official death toll of 64. Hurricane Maria triggered one of the longest power blackouts in history and left many Puerto Ricans without access to potentially life-saving needs.

Rodríguez-Wiewall said having no power means potentially no access to digital patient records, no ability to keep medication such as insulin or certain vaccines at the correct temperature, and an inability to power necessary medical equipment.

The needs in Puerto Rico have been great, she said, pointing out that the island has been in a state of emergency for five years: first Hurricane Maria in 2017, then a wave of earthquakes in the island’s southern region in early 2020, the pandemic, and now Hurricane Fiona.

On Thursday, volunteers were dropping off food and supplies in the community of Tiburones, in the southern town of Ponce, amid a sweltering heat wave that compounded the struggles of those without power and water. The area had flooded during the storm as two nearby rivers overflowed. The leftover smell of water and salt remained on the ground, and residents described seeing live fish in the waters that flowed into their neighborhood.

Carmen Rodríguez, 50, a community leader who was born and raised in Tiburones, described her fear during the storm as she saw Fiona’s rain.

“It was so strong. When I saw the river was rising so quickly, I knew it was going to get into all of the homes,” she said in Spanish. “It was worse than Maria, truly.”

Rodríguez said the area still doesn’t have power and, although it now has a bit of running water, the pressure is nowhere near enough yet to help residents clean their homes or meet their other needs.

The Direct Relief Puerto Rico team came to the neighborhood to bring 10 portable oxygen concentrators and other supplies to partners in the area.

One of the oxygen concentrators was for Edwin Quiles Martínez, 66, a U.S. Marine veteran with chronic obstructive pulmonary disease and diabetes. He has had trouble breathing for 10 years now, and the extreme heat and lack of power following Fiona is making it worse.

Image: Edwin Quiles Martínez, 66, and his wife Graciela Pérez Alvarado, 73, in their home in Ponce, Puerto Rico.
Edwin Quiles Martínez, 66, and his wife Graciela Pérez Alvarado, 73, in their home in Ponce, Puerto Rico.Daniella Silva / NBC News

“This machine will help me a lot,” he said between heavy breaths, sitting outside his home shirtless and in denim shorts, occasionally wiping his brow.

Family members have been helping him and his wife, Graciela Pérez Alvarado, 73, take out a series of black trash bags full of debris from where the floodwaters entered their home, leaving the smell of mold and dampness. 

Pérez Alvarado sighed as she looked around her home and all of the work that needed to be done. For her, this storm was also worse than the impact of Maria.

A lifelong resident of Tiburones, she grew emotional and said in Spanish, “I don’t even want to live here anymore.”

Daniella Silva reported from Puerto Rico, and Nicole Acevedo from New York.

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