Breaking News
June 22, 2018 - Robotic surgery appears to be as effective as open surgery in treating bladder cancer
June 22, 2018 - Many Drugs Made Available Via FDA Expanded Access Programs
June 22, 2018 - Normal eye dominance is not necessary for restoring visual acuity in amblyopia
June 22, 2018 - Parent-Child Interaction Therapy can reduce depression rates in children
June 22, 2018 - Study provides insights into how components of different cells in the brain are altered
June 22, 2018 - Research does not confirm antidiabetic action of natural fatty acid derivatives
June 22, 2018 - Oxidative stress can be used against tumors to treat cancer
June 22, 2018 - Simple, cost-effective test may help improve early diagnosis of mild cognitive impairment
June 22, 2018 - New guide published to help battle fatal disease caused by kissing bugs
June 22, 2018 - Stigma Adds to Burden of Type 1 Diabetes
June 22, 2018 - In retinoblastoma survivors, oculo-visual issues tied to QoL
June 22, 2018 - Most adults with allergies do not use prescribed epinephrine even in emergency situations
June 22, 2018 - Study provides clues to how cancer cells develop resistance to chemotherapies
June 22, 2018 - New consensus paper serves as basis for uniform medical management of DSD
June 22, 2018 - Researchers work to identify areas of the brain that help us wake up
June 22, 2018 - Alcohol hangovers more significant and costly than people realize, shows research
June 22, 2018 - Targeting cells involved in blood vessel formation could hinder brain tumor growth
June 22, 2018 - Young cancer survivors need more support as they feel dissatisfied with their sexuality
June 22, 2018 - Unusual cell-to-cell communication in glioblastoma promotes aggressiveness and therapy resistance
June 22, 2018 - Turning A Phage – Drug Discovery Today
June 22, 2018 - World-first study links birth interventions and long-term childhood illness
June 22, 2018 - Improving the quality of biomedical research samples
June 22, 2018 - Researchers identify cerebral palsy using AI and DNA sequencing
June 22, 2018 - Administering nitric oxide gas after heart surgery may decrease risk of kidney problems
June 22, 2018 - Measuring levels of ethyl sulphate in hair can help assess alcohol consumption
June 22, 2018 - Researchers develop robot bloodhound that can rapidly detect odors on the ground
June 22, 2018 - AAA doses first patients in two clinical studies with PSMA-R2 for prostate cancer
June 22, 2018 - Normalization of ‘plus-size’ body shapes may prevent recognition of health risks of obesity
June 22, 2018 - UC San Diego launches new bacteriophage therapy center
June 22, 2018 - New review outlines current state of sex-sensitive issues linked to heart failure drugs
June 22, 2018 - Pelvic pain a major issue for women nearing mid-life, research reveals
June 22, 2018 - Researchers develop reliable DNA barcodes for biomedical research
June 22, 2018 - New risk-prediction model may help identify diabetic patients at high risk of pancreatic cancer
June 22, 2018 - Study reveals how mTORC1-driven changes in crowding could influence major diseases
June 22, 2018 - Researchers uncover new therapeutic opportunity in the treatment of malignant melanoma
June 22, 2018 - UC Riverside researcher receives grants to advance cancer, ALS research
June 22, 2018 - Radiation therapy alone may be enough to treat older, sicker patients with anal cancers
June 22, 2018 - Technical report describes how to make accurate particle size measurements on carbon black samples
June 22, 2018 - Nocdurna (desmopressin acetate) Approved by FDA as First Sublingual Tablet to Treat Nocturia due to Nocturnal Polyuria
June 22, 2018 - Neuroscientists locate neurons in the brain that respond when a visual target is found
June 22, 2018 - First human Keystone virus infection reported
June 22, 2018 - New study reveals how ‘good’ bacteria help in regulating our metabolism
June 22, 2018 - Osteopathic manual therapy affecting the diaphragm improves chronic low back pain
June 22, 2018 - Researchers create revolutionary model to study pulmonary diseases
June 22, 2018 - Diagnosing Heart Disease Using AI
June 22, 2018 - Increasing biodefense risks posed by synthetic biology
June 22, 2018 - Many Women Report Vasomotor Symptoms in Their 60s
June 22, 2018 - Rare mutation of gene carried by Quebec family gives insight into how the brain is wired
June 22, 2018 - Chemists find new way to make enzymes do a non-natural reaction
June 22, 2018 - Summer is good time to check for signs of skin cancer
June 22, 2018 - Innovative method can help identify patients with spastic cerebral palsy
June 22, 2018 - Exercise alters characteristics of blood to reduce inflammation in obese people
June 22, 2018 - Researchers examine complications across different types of breast reconstructive surgeries
June 22, 2018 - Rhesus macaque model could be useful to test therapies for congenital Zika virus syndrome
June 22, 2018 - AHA: New Insights Into Sickle Cell and Stroke Risk
June 22, 2018 - Doctors prescribe opioids at high rates to those at increased overdose risk
June 22, 2018 - Reduction in US cigarette smoking rates
June 22, 2018 - Preconception binge drinking may have negative effect on future offspring
June 22, 2018 - FDA expands approval of novel diabetes management device to include younger pediatric patients
June 22, 2018 - Researchers confirm weight loss benefits of the 16:8 diet
June 22, 2018 - FDA approves Eversense CGM system for use in adults with diabetes
June 22, 2018 - State opioid monitoring programs are not created equal
June 22, 2018 - Autistic teens who are bullied have higher rates of depression
June 22, 2018 - Penn Medicine team launches universal stroke awareness program
June 22, 2018 - Scientists discover the molecular trigger of necroptosis
June 22, 2018 - Researchers report unusually high levels of herpesvirus in the brains of people with Alzheimer’s disease
June 22, 2018 - Theoretical models predict how juveniles evolve to be more susceptible than adults to infection
June 22, 2018 - USC study reveals how the cell launches emergency response to repair damaged DNA
June 22, 2018 - $1.9 million grant aims to enhance behavioral health services in community-based settings
June 22, 2018 - New 3D imaging technique could improve arthritis treatment
June 22, 2018 - Cytokinetics Announces Data From Phase 2 Clinical Study of Reldesemtiv in Patients With Spinal Muscular Atrophy
June 22, 2018 - Polarized cells give the heart its fully developed form
June 21, 2018 - Stem cells appear to help fight obesity in animal models
June 21, 2018 - Harnessing Pediatric Cancer Genomic Data in the Cloud
June 21, 2018 - Training nursing students with cost-effective 3D-printed task trainers
June 21, 2018 - Study provides insight into how planned and spontaneous movements are processed in the brain
June 21, 2018 - Suicide Prevention | SAMHSA – Substance Abuse and Mental Health Services Administration
June 21, 2018 - From designer microbes to stem cells, researchers are investigating new strategies to treat bowel disease
June 21, 2018 - Study suggests state-of-the-art genomic testing for routine autopsy of stillbirths
June 21, 2018 - Christiana Care Health System opens first Epilepsy Monitoring Unit in Delaware
The frail in Puerto Rico face end of hurricane relief programs

The frail in Puerto Rico face end of hurricane relief programs

image_pdfDownload PDFimage_print

“See, that tree broke off that branch, which is as thick as a tree — and now it’s in my yard,” said Maldonado, a 65-year-old retiree.

The downed tree — and the rats attracted to it —prevent Maldonado from hanging his laundry. To get the tree removed, he must show up at a local government office. But the diabetic ulcers on his feet make it painful for him to walk.

After a lifetime of work on the U.S. mainland, picking corn and asparagus and processing chickens in poultry plants, Maldonado returned to Puerto Rico a decade ago to help care for his ailing mother, who has since died. Today the retiree finds himself living day to day on the island. He receives $280 a month in Social Security and $89 a month in food stamps — which alone covers about $3 a day for food.

Six months after Hurricane Maria devastated Puerto Rico and its economy — and killing by some estimates at least 1,052 people — the daily indignities are piling up, especially for people who are frail or elderly. Many are finding their current economic straits nearly as threatening as the storm.

The storm also crippled the island’s power grid, and as of Sunday 86,000 utility customers still had no electricity in their homes and businesses, affecting hundreds of thousands of people.

In the island’s central mountain region, entire towns and neighborhoods continue to rely on finicky and expensive gas-fueled generators, putting the elderly and chronically ill who depend on ventilators and sleep apnea machines at risk. Many homes along the island’s mountainous roads remain entirely in the dark and do not have clean water.

The emergency government support that helped pay for some health care services and medically related transportation needs of Puerto Ricans after Hurricane Maria is running out. Private donations of water and food have slowed. And it’s not clear who, if anyone, will carry on with that work.

Maldonado opened the cupboards in his tidy kitchen. There are a few cans of corned beef, SpaghettiOs and beans. He sounds wistful about what he likes to cook.

“When I have enough food, when I do my groceries,” he said, “I have eggs and bread and coffee and juice for breakfast. I would make spaghetti or some sort of salad and maybe a little dessert” for dinner.

But the oven is unplugged, and there is no juice or eggs or lettuce. It has been months, Maldonado said, since he has had fresh vegetables in the house.

“When there’s very little, then I kinda go on a diet,” he said.

It was hard enough for the retiree to fill his cupboards before the storm, but now, as many aid groups are winding down their donations, Maldonado needs to find money to buy clean, bottled water and to replace his refrigerator, which was ruined during the hurricane.

To buy groceries, he must wait two weeks for his next Social Security check.

“I’m waiting until the 10th so I can go do my grocery shopping again — if I can find a way to get there,” Maldonado said. “That’s when I would have food again, enough to make three meals — lunch, breakfast and dinner.”

Maintaining a decent diet isn’t simply about staving off hunger; diabetes is consuming Maldonado’s foot, and unless he eats healthy food and takes his insulin, doctors have warned him, his foot will need to be amputated.

Maldonado opens the door to his broken refrigerator and points to a vial that holds a few drops of insulin — the last of his supplies until he can afford the $3 copay for refills and find a ride to the pharmacy.

“The pharmacist said it could be stored in a dark place [without refrigeration] for a couple of weeks,” he said.

Ideally, insulin should be kept cool, but broken refrigerators and a lack of power in many homes in Puerto Rico pose grim hazards for the island’s expanding population of people with diabetes.

A visiting nurse, Leslie Robles, who checks on Maldonado monthly, examined the 3-inch-long, gaping wound on his foot. They sat at the kitchen table under a print of Leonardo da Vinci’s “The Last Supper” and sifted through piles of paperwork for Maldonado’s upcoming cataract surgery.

Robles told him that the free medical transportation service the government made available to large numbers of people after the storm is expiring soon, and he’ll no longer qualify for free rides.

But she doesn’t tell him the visiting nurse program she works for, operated by VarMed, a health care management company whose services had been paid for by the government, is shutting down, too.

VarMed has been helping coordinate medical care, social services and housing for thousands of Puerto Ricans for four years. The company, in recent weeks, laid off more than 100 nurses and social workers across the island, as the local government seeks to overhaul its Medicaid contract with insurance companies.

It is unclear how much longer Robles will be able to help Maldonado, and other patients like him, who are on Medicaid and have complex medical needs — the “high cost, high need” patients on the island.

The government wants Medicaid-contracted insurers to develop their own programs for these patients, but the earliest that would happen is this fall.

In the meantime, Maldonado said he has no one to help him shop for groceries, fill prescriptions and get to doctor’s appointments; the volunteers who helped him survive Hurricane Maria are returning to their own lives.

In many ways, he, too, is returning to the same spartan life he had before the storm. But with a weakened island safety net that continues to unravel, and with his own health increasingly tenuous, Maldonado said he feels alone.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles