Eight months after Hurricanes Irma and Maria devastated Puerto Rico, the day-to-day crises are far fewer for most of us, but the island remains a profoundly changed place. One of the most pernicious challenges is electricity. Few people had power after Irma and no one had power after Maria, which hit Puerto Rico on September 20, 2017. Local outages are a daily reality; large-scale blackouts occur occasionally; and tens of thousands of households have yet to be reconnected to the grid.
In this vacuum, generators have become commonplace among those who can afford them. The rumble of generators now often drowns out the calls of the coquí frogs, but they keep us going, like the one powering the computer I am writing on right now.
I work for the Dengue Branch of the Centers for Disease Control and Prevention (CDC), located in San Juan, which is charged with reducing the impact of dengue globally. Our branch maintains a collection of hundreds of thousands of frozen biological samples, and maintaining those freezers in the event of electrical outages is a longstanding concern.
But until Irma and Maria struck, I had not appreciated the full extent of our dependence on electricity. Expensive laboratory equipment can easily be damaged by surges or sudden lapses in power. Computers, servers and the network we rely on are equally susceptible to these fluctuations. And all of the equipment is highly sensitive to heat and humidity, the norm for this tropical island. Without electricity, there is no climate control, and mold and rust are quick to attack.
Thankfully, our main generator never failed, and our backup generator kept the freezers cold through periodic maintenance until power was restored to our facility on January 16, 2018, almost four months after Maria. Still, as a precaution, we shipped thousands of samples to Atlanta as a backup in November.
But we weren’t the only public-health organization that faced a potential crisis. The Puerto Rico Department of Health laboratories sustained substantial damage, requiring a collaborative effort to temporarily provide off-island testing for priority infectious diseases. That testing is still being transitioned back.
Even with electricity, laboratory equipment requires recertification prior to being used for diagnostic testing, and for months, certified technicians and parts for specialized equipment were thousands of miles away with limited options to fly to Puerto Rico, find a hotel room in San Juan or even send parts.
Compounding these challenges, those of us working in public health are not just working to get public health back up and running but also to put our own lives back together. Simply plugging the computer in again does not change our altered reality. Our minds are still elsewhere much of the time, we still need to repair our homes, keep the gas tank full and maintain a supply of non-perishable food, water and batteries for the next blackout.
Maria was traumatic, and the months of struggle afterwards even more so. In addition to the tens of thousands of people still without electricity, many more are living under tarps, and the number who have emigrated or died is unclear. Isolation, an unprecedented fiscal crisis, and high levels of poverty added to the challenges.
Constant uncertainty and unstable electricity, water, food and fuel try everyone’s patience but have also brought out the best in us. People are the greatest asset to public health, the CDC Dengue Branch and Puerto Rico. Everywhere, people are being creative and helping family, friends and communities.
And here we are, working to rebuild but unsure when local laboratories will be functioning at full capacity, when the power will come back at home, when the grid will be reliable, what will happen if we have a medical emergency, and whether another hurricane will head our way this year. Maria and her aftermath have taught us a lot, about preparedness, community, resilience and fragility.
Note: The opinions and views expressed here are those of the author and do not represent positions of the Centers for Disease Control and Prevention.