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U.S. Department of Health and Human Services


HHS’ efforts better prepared Puerto Rico, U.S. Virgin Islands for Dorian

Author: Mike Cote, Federal Health Coordinating Official and Regional Administrator
Published Date: 8/30/2019 8:01:00 AM
Category: Response & Recovery; Public Health Preparedness; Hospital Preparedness;

Hurricane Dorian didn’t deliver the damage, destruction, and mass patient caseload to Puerto Rico and the U.S. Virgin Islands that many people anticipated the storm would — and that’s a good thing. Nevertheless, Puerto Rico was ready for a hurricane in a way it has never been before thanks to the efforts by HHS’ Division of Recovery team.

Over the past two years, federal and territory government agencies and non-government organizations have worked together to prepare Puerto Rico and the U.S. Virgin Islands healthcare systems for hurricanes and other natural disasters. These U.S. territories are still recovering from Hurricanes Irma and Maria, which devastated the islands in 2017, and a direct hit from Dorian could have undone much of the hard work done over the last two years.

For example, the ASPR Division of Recovery worked diligently with the Puerto Rico Department of Health to facilitate regionalized networks of hospitals, primary care facilities, dialysis centers, emergency medical services, and emergency management. These networks have greatly advanced the situational awareness, logistics, plans, supplies, and other response mechanisms across the island.

Dr. Elaine Kolodziej, from Centro de Medico, thanks HHS staff for preparedness efforts in Puerto Rico.
Dr. Elaine Kolodziej, from Centro de Medico, thanks HHS staff for preparedness efforts in Puerto Rico.

Through these networks — a healthcare coalition — hospitals, federally qualified health centers, clinics, and other key healthcare facilities can support each other better during disasters. Local healthcare facilities can transfer or refer patients easily to regional hospitals to keep local facilities from getting overwhelmed; hospitals also can transfer or refer patients to the trauma center. Regional hospitals also have systems in place to allocate resources like generator fuel or medical supplies to help local hospitals.

The Puerto Rican Department of Health now has a system in place to monitor the real-time status of hospitals on the island so it knows when hospitals are open, closed, on generator power, or likely to need generator fuel when the power is out for an extended period of time. Sharing resources, situational awareness, and a common operating picture for meeting the medical needs at the regional level helps ensure there are no shortfalls.

Territory organizations now have the tools and resources they didn’t have before to help people with access and functional needs for the most vulnerable populations — children, the elderly, and people who are at-risk because of their health conditions.

The U.S. Virgin Islands’ hospital has greater dialysis capability than in the past to support more dialysis patients if regular dialysis centers are not available after storms.

Thankfully, Dorian’s impact to Puerto Rico and the U.S. Virgin Islands was not significant, but the storm presented an opportunity to test and evaluate the progress the territories have made with help of the ASPR Division of Recovery since Hurricanes Irma and Maria. Health officials and emergency managers know that the question is not “if,” but “when” the territories will face another impactful storm — but it was Hurricane Dorian that proved Puerto Rico and the U.S. Virgin Islands are more resilient, stronger, and better prepared to face the challenges brought by future disasters.

Visit to learn more about disaster recovery for health and social services, including tools that can help health and emergency managers plan for and recover from disasters more effectively. The guides, sample plans, measures and other tools can help you learn more about your community and leverage resources to help your community recover.


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