Impact of Hurricanes Irma and Maria on Puerto Rico Maternal and Child Health Research Programs

Abstract

Puerto Rico was hit by two major hurricanes in September 2017 causing great devastation, losing over 90% of the power grid, wireless communication and access to potable water, and destroying many homes. Our research programs: Puerto Rico Testsite for Exploring Contamination Threats (PROTECT), Center for Research on Early Childhood Exposure and Development in Puerto Rico (CRECE), Zika in Infants and Pregnancy (ZIP), and Environmental Influences on Child Health Outcomes (ECHO) are ongoing observational cohort studies that have been investigating environmental risk factors for perinatal health outcomes among Puerto Rican mothers and infants. Our projects paused operations for about two weeks, to begin recovery process and become a source of assistance, retaining 95% of study participants across all research programs. We joined with various groups to ensure the safety and welfare of team members, study participants, community health center partners, and members of the surrounding communities. We learned important lessons about the impact of these hurricanes and the difficulties of the recovery. Major challenges post-hurricanes were access to care and nutrition, maternal stress, and environmental damage. We understood the need to integrate disaster preparedness into our programs' operating procedures and future applications, recognizing that these events will recur. We will grow resilience among our staff, maternal and child health partners, and participants by building on the experience of these two storms.

Pregnant Women’s Experiences during Hurricane Maria: Impact, Personal Meaning, and Health Care Needs

“…One aspect was securing transportation to pharmacies and clinics due to loss of public transit. Further, many pharmacies were closed due to lack of electricity and those pharmacies that were open usually lacked internet access to verify prescriptions [21]. Despite that, all our participants received the care they needed; in the advent of Hurricane Maria, access to health was one of the main concerns of the participants of our study.…”

“…Access to adequate perinatal care following a natural disaster can be a challenge for new and expecting mothers. Women are more likely than men to receive inadequate health care following a natural disaster and the consequences are more severe for pregnant women due to the needs of the developing fetus [21][22][23]. A study that observed the impact of Hurricane Irma and Maria on Maternal and Child Research Programs explains how access to continued health care was a major issue in the wake of both hurricanes.…”

The Changing Climate and Pregnancy Health

“…The frequency and intensity of extreme weather events such as hurricanes and floods are expected to increase. Hurricanes reduce access to safe food and water, and induce stress by disruption of existing infrastructures [71][72][73][74]. During a hurricane, pregnant women report significant fear of losing home and/or job, and serious concerns about the health of their baby and the birth process [75][76][77].…”

The Impact of Natural Disasters on Maternal Health: Hurricanes Irma and María in Puerto Rico

“…Thus, individual, community and state responsibilities in terms of access to resources need be addressed during emergency preparedness. For example, in PROTECT we have provided participants, after consulting them, with materials like water filters, mosquito nets, powdered milk, and baby products, as well as educational material related to emergency preparedness aimed at pregnant and post-partum women (i.e., infographics from CDC and local authorities, materials developed by the PROTECT team) [ 33 ]. In addition, state and local agencies and institutions must work on emergency preparedness that responds to the specific needs of diverse communities and populations such as pregnant and post-partum women and provides them with access to resources [ 18 , 34 ].…”