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U.S. Department of Health and Human Services


Complex, Challenging, and Rewarding: Developing Strategies to Support Health and Human Services Recovery in Puerto Rico

Author: By Melanie Deal, Health Communications Specialist, HHS Health Resources and Services Administration
Published Date: 2/7/2019 8:22:00 AM
Category: Response & Recovery;

Almost a year and a half after Hurricane Maria struck Puerto Rico, people across the island are still haunted by the memories of the devastating storm, and communities are still recovering. During a recent deployment to Puerto Rico to support disaster health recovery, I learned that recovery is truly a marathon that can take years. I am dedicated to helping people cope, heal and recover, and I have been honored to work with a great team for the Health and Social Services Recovery Support Function, managed by ASPR.

I was greeted with a “bienvenida” (“welcome” in Spanish) from a team composed of 90 percent local hires. This local team was key in the success of health and social services recovery projects because they provided a strong local perspective. That perspective helped us develop effective strategies and strengthen collaboration among our many partners to collaborating between all sectors on the island.

As part of the team, I coordinated a new type of training called Skills for Psychological Recovery for a variety of community groups in Puerto Rico. This evidence-based training provides responders and personnel who work directly with children and families with the skills they need to manage distress, cope with post-disaster stress, and to assist others.

Communities across the island continue to overcome widespread and complex behavioral and mental health challenges. To meet the needs of survivors and responders, we worked with many of the people on whom residents already rely for help: local social services providers and faith-based communities. We led eight training workshops with 177 responders from the Puerto Rico Department of Families and Puerto Rico Chaplain Corps. The positive response to the training was tremendous, and these groups now use the skills they learned when they go out to their communities.

Under HSS RSF, ASPR also worked with the government of Puerto Rico to enhance understanding of the broader healthcare system’s capabilities through the Capacity and Capability Assessment for Healthcare Centers. I got to be part of a team that worked with local personnel to apply a tool for assessing hospitals, diagnostic and treatment centers, and health clinics including Federally Qualified Health Centers to determine their capacity to respond to future emergencies.

For these assessments, we visited each healthcare center facility in Puerto Rico. I visited eight facilities and, in all of them, I witnessed the commitment of the administrators to share information and collaborate. Based on the data collected, the team created a snapshot of all healthcare centers in Puerto Rico in one map for an at-a-glance view on data that will be critical to respond better in the future.

Being part of recovery operations in Puerto Rico was especially meaningful for me. Much of my family lives on the island, and for a long time after the storm, I didn’t know if they were okay. Even after I learned that everybody in my family was safe, I knew that many other families weren’t as fortunate and I wanted to use my skills to help people recover.

While supporting recovery efforts in the field, I saw much people rely on health and social services in disasters and every day. On a daily basis, I manage health communications for organ transplant programs. In 2018, 122 people in Puerto Rico received transplanted organs, and about 350 people are currently on the waiting list. My agency, the Health Resources and Services Administration (HRSA) also provides funding for federally qualified health centers. For the mapping project, one of the HRSA-funded centers I visited had taken extraordinary preparedness steps long before the 2017 hurricane season; that center was one of the few fully functioning after the Hurricane Maria; it was available when people relied on it most. The center clearly demonstrated how having robust systems day-to-day can save lives in disasters.

I’ve worked on a wide range of public health challenges during my time in government service, but none of them were as complex, challenging, and rewarding as being a part of the recovery efforts in Puerto Rico. I am honored to be a part of the recovery effort and more proud than ever of the work we do day in and day out at HHS.

-Melanie Deal is a health communications specialist with HRSA’s Division of Transplantation which is the primary federal entity responsible for oversight of the organ and blood stem cell transplant systems in the U.S. and for initiatives to increase organ donor registration and donation in this country.


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