We Still Don’t Know How Many Have Died In Puerto Rico After Hurricane Maria

There could be hundreds more dead than is currently being reported in the official tally.

Omaya Sosa Pascual September 29, 2017

Nilka Fontánez asked the Emergency Operations Center for help but was told they are not accepting patients there. Her father Pedro Fontánez, 79, is bedridden at Pavía Hospital and lacks electricity at home to support the oxygen and gastric tube-feeding he needs. (Omaya Sosa/El Centro de Periodismo Investigativo)

This arti­cle orig­i­nal­ly appeared at El Cen­tro de Peri­odis­mo Inves­tiga­ti­vo.

Since the hurricane, many people have gone daily to radio stations so that the on-air personalities can say the names of family members with whom they have been unable to communicate in a desperate attempt to find them.

Leovig­ildo Cot­té died in the midst of des­per­a­tion over not get­ting the oxy­gen need­ed to keep him alive in the only shel­ter that exists in the town of Lajas, which has been with­out elec­tric­i­ty since the pass­ing of Hur­ri­cane María a week ago. Not even his con­nec­tions with the gov­ern­ment saved him.

The gen­er­a­tor nev­er arrived,” said the cur­rent may­or of Lajas, Mar­cos Turín Irizarry, who explained that he looked for oxy­gen for Cot­té, father of the for­mer may­or of that same town, turn­ing every stone,” but could not find it.

Cot­té is one of the unac­count­ed vic­tims of the Cat­e­go­ry 5 hur­ri­cane that dev­as­tat­ed all of Puer­to Rico last week, with its sus­tained winds and gusts of up to 200 miles per hour. On Wednes­day, the Gov­ern­ment of Puer­to Rico, still held that the offi­cial num­ber of deaths as a result of the cat­a­stro­phe was 16, but the El Cen­tro de Peri­odis­mo Inves­tiga­ti­vo (CPI) has con­firmed that there are dozens and could be hun­dreds in the final count.

The fatal­i­ties relat­ed to cir­cum­stances cre­at­ed by the hur­ri­cane are still mount­ing with each pass­ing day, and offi­cial num­bers are not count­ing patients who are not receiv­ing dial­y­sis, oxy­gen and oth­er essen­tial ser­vices, such as Pedro Fontánez, 79, who is bedrid­den at the Pavía Hos­pi­tal in San­turce and who the insti­tu­tion is attempt­ing to release since Sat­ur­day, while he lacks elec­tric­i­ty at home to sup­port the oxy­gen and gas­tric tube-feed­ing he needs to con­tin­ue liv­ing. His daugh­ter Nil­ka Fontánez showed up des­per­ate at the government’s Emer­gency Oper­a­tions Cen­ter ask­ing for help, but was told they were not accept­ing patients there.

There’s no infor­ma­tion,” she said frustrated.

The dead are at the hos­pi­tal morgues, which are at capac­i­ty and in remote places where the gov­ern­ment has yet to go, and in many cas­es, their fam­i­lies are unaware of the deaths. The Demo­graph­ic Reg­istry cer­ti­fies the deaths so bod­ies can be removed by funer­al homes, many of which are also not oper­at­ing for a lack of resources and fuel. They bare­ly began cer­ti­fy­ing some of the dead on Mon­day, as Health Sec­re­tary Rafael Rodríguez-Mer­ca­do con­firmed in an interview.

Pub­lic Safe­ty Sec­re­tary Héc­tor Pes­quera told CPI that the names of the dead due to the hur­ri­cane will not be revealed, as the lack of com­mu­ni­ca­tion has kept many peo­ple from know­ing the where­abouts of their fam­i­lies. Since the hur­ri­cane, many peo­ple have gone dai­ly to radio sta­tions so that the on-air per­son­al­i­ties can say the names of fam­i­ly mem­bers with whom they have been unable to com­mu­ni­cate in a des­per­ate attempt to find them.

A week after María’s pas­sage, the gov­ern­ment of Puer­to Rico is try­ing with great dif­fi­cul­ty to sup­ply basic ser­vices, such as fuel, roads and com­mu­ni­ca­tions and tells the world every day of the progress of these efforts through their press con­fer­ences at the Emer­gency Oper­a­tions Cen­ter (COE, for its ini­tials in Span­ish) estab­lished in San Juan. But the fact that is not dis­cussed is that the num­ber of deaths result­ing from the dis­as­ter are much high­er than the 16 or 19 that have been offered as the offi­cial tally.

CPI sources in half a dozen hos­pi­tals said those bod­ies are pil­ing up at the morgues of the 69 hos­pi­tals in Puer­to Rico, of which 70% are not oper­at­ing. The major­i­ty of the hos­pi­tal morgues that pro­vid­ed infor­ma­tion includ­ing Doctor’s Cen­ter in Bayamón and San­turce, Pavía Hos­pi­tal in San­turce, the Man­atí Med­ical Cen­ter, Dr. Pila in Ponce, the Río Piedras Med­ical Cen­ter, the Mayagüez Med­ical Cen­ter and the HIMA hos­pi­tals in Caguas and Bayamón, are at full capac­i­ty. Those hos­pi­tals are among the 18 that are par­tial­ly operational.

Fur­ther­more, this media out­let learned that the Insti­tute of Foren­sic Sci­ences is also full of bod­ies and that alleged­ly 25 of those are hur­ri­cane vic­tims. On Tues­day, the IFS informed that it had increased its stor­age capac­i­ty for bod­ies with a trail­er that was obtained through The Morgue fed­er­al program.

It’s unclear what is hap­pen­ing with the deceased that are at the morgues of the 51 hos­pi­tals that have had to close their doors, with which it has been impos­si­ble to communicate.

Sec­re­tary Rodríguez-Mer­ca­do acknowl­edged that hos­pi­tal morgues are full, includ­ing the one at the Med­ical Cen­ter in Mayagüez. He said the accu­mu­lat­ed bod­ies can­not be removed from the morgues by funer­al homes until the deaths can be cer­ti­fied by the Demo­graph­ic Reg­istry, who bare­ly began oper­at­ing from region­al emer­gency cen­ters on Monday.

Fur­ther­more, the doc­tor acknowl­edged that the hur­ri­cane-relat­ed deaths are many more than those offi­cial­ly doc­u­ment­ed so far. As he said Mon­day, the three hos­pi­tals he vis­it­ed that day in the island’s west­ern region, dur­ing the first con­tact he was able to achieve with that region, he doc­u­ment­ed sev­en addi­tion­al deaths to the 19” that had been revealed so far. That same after­noon, Gov. Ricar­do Rossel­ló said the offi­cial fig­ure of hur­ri­cane-relat­ed deaths was still 16.

To date, Rodríguez did not know the sta­tus of the sit­u­a­tion at the hos­pi­tals in Ponce, because the region remained com­plete­ly cut off from com­mu­ni­ca­tions, but planned to go to that town on Tues­day to explore the mat­ter. On Wednes­day, CPI learned through Ponce May­or María Mayi­ta” Melén­dez that the hos­pi­tals oper­at­ing in that town are San Cristóbal and San Lucas.

We’re find­ing dead peo­ple, peo­ple who have been buried. Relat­ed to the hur­ri­cane (we have) 19 dead, which the gov­er­nor report­ed, but (peo­ple) have made com­mon graves. We’ve been told peo­ple have buried their fam­i­ly mem­bers because they’re in places that have yet to be reached,” the Sec­re­tary told CPI, while vis­i­bly shaken.

The sce­nario is not opti­mistic. The hos­pi­tals that closed their doors dur­ing the week that the emer­gency has last­ed have more than 4,000 beds, and when asked what hap­pened to those patients, where they were trans­ferred, the Sec­re­tary respond­ed with a sin­cere I don’t know.”

CPI sources said that in just two of the hos­pi­tals that are oper­at­ing, they were they able to doc­u­ment a dozen deaths among patients that were trans­ferred out of the closed-down hos­pi­tals. Fur­ther­more, they point­ed out that the prob­lem is that patients are arriv­ing in crit­i­cal con­di­tion, with ven­ti­la­tors, for exam­ple, and with poor­ly doc­u­ment­ed records regard­ing what had hap­pened at the insti­tu­tion where they were hos­pi­tal­ized. For that rea­son, and the lim­i­ta­tion of resources and fuel for pow­er gen­er­a­tors, the major­i­ty of hos­pi­tals that are oper­a­tional” are not accept­ing trans­fers or new patients, they said. The Río Piedras Med­ical Cen­ter, the government’s main hos­pi­tal for this dis­as­ter and the only ter­tiary hos­pi­tal in Puer­to Rico, has been oper­at­ing at half capacity.

Rodríguez-Mer­ca­do said Wednes­day that on that same day, they would meet with spe­cial­ized author­i­ties from the U.S. Depart­ment of Health to dis­cuss the pro­to­cols used to han­dle cadav­ers to pre­vent a bud­ding pub­lic health prob­lem. He said the cur­rent pro­to­col for dis­pos­ing bod­ies and veg­e­ta­tive mate­r­i­al in emer­gency sit­u­a­tions is man­aged by the Envi­ron­men­tal Qual­i­ty Board. But soon after, the pres­i­dent of that agency, Tania Vázquez, said in an inter­view that her agency only over­sees the pro­to­col relat­ed to dis­pos­ing of ani­mals, not human beings, but added that bury­ing a dead per­son with­out a cer­ti­fi­ca­tion of the death is a crime. As of press time, the Gov. Ricar­do Rosselló’s press sec­re­tary had not respond­ed to a peti­tion to clear up who is respon­si­ble for the pro­to­col for these emer­gency burials.

Mean­while, the dead con­tin­ue to accu­mu­late as a result of the chaos in the health sys­tem due to a lack of diesel and the absence of a com­mu­ni­ca­tions plan between the system’s com­po­nents, and these must be added to those who are in areas that still lack com­mu­ni­ca­tion and those in remote areas.

We’re fight­ing. I would love for the gov­ern­ment to under­stand that it has to open dial­y­sis cen­ters. If they don’t receive the ser­vice, the patients’ health is com­pro­mised quick­ly and they die. And yes, they have died,” Arman­do Rodríguez, vice pres­i­dent of Grupo HIMA con­fessed when con­firm­ing that the morgues of his two hos­pi­tals in Bayamón and Caguas is above capacity.

Mean­while, thou­sands of doc­tors and nurs­es are lit­er­al­ly at home unable to work, said Dr. Joaquín Var­gas, pres­i­dent of the Puer­to Rico Pri­ma­ry Physi­cians Groups Asso­ci­a­tion, who was at the COE to see if the gov­ern­ment would set up an oper­a­tions cen­ter where they could at least answer calls from citizens.

CPI also learned that a large por­tion of spe­cial­ized physi­cians is unable to work because hos­pi­tals don’t have sup­plies and the abil­i­ty to con­duct their pro­ce­dures, nor basic resources such as fuel or elec­tric­i­ty to run their med­ical practices.

Omaya Sosa Pas­cual is an award-win­ning inves­tiga­tive jour­nal­ist and new media entre­pre­neur with 20 years of expe­ri­ence. She is the found­ing co-direc­tor of El Cen­tro de Peri­odis­mo Inves­tiga­ti­vo and co-founder of Noti​Cel​.com, a dig­i­tal news out­let. Fol­low her on Twit­ter @omayasosa.
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