BATTLE GROUND — Almost two months after Hurricane Maria devastated Puerto Rico, first-response teams finally reached the most isolated villages.
Dr. Beth Lee and Dr. Art Simons were part of a relief effort that deployed some of those teams, including chain-saw crews, to remote mountain communities. The husband-and-wife physicians spent a week in Puerto Rico as volunteers for Team Rubicon, a nonprofit organization.
After seeing news coverage of the devastation, the Battle Ground couple — who retired from their medical practice in 2011 — decided to put their skills to use again.
“We saw these things and couldn’t sit on the sidelines,” Simons said.
Lee went online to offer their medical services and Team Rubicon was the first group to respond.
Lee, 62, and Simons, 63, spent a week working in Puerto Rico, from Nov. 7 through Nov. 14. They were based at Aricebo, along the northern coast, where they set up a clinic in a sports arena. While some volunteers ran that clinic, others formed mobile teams and headed into the interior. Each team consisted of a doctor, a nurse, a medic and a Spanish-speaking translator.
The same things that made the entire island a disaster site made it a tough place to practice medicine.
Just getting to some villages meant that the first wave of Team Rubicon volunteers packed chain saws. After they cleared the roads, “Our medical teams would follow,” Lee said.
Even when the roads were cleared, getting around wasn’t easy, Simons said: “Road signs had been blown away.”
When they arrived in a village, he said, “We would ask if there was anybody they were worried about.”
Then, local residents would start arriving at the mobile clinic. Without labs or diagnostic equipment, the doctors did what they could.
In addition to the most basic question for a patient — “What are you here for?” — the teams had another key question for their patients, Lee said.
“Do you have water and power?”
Issues with water
Bottled water is expensive. So when a woman came in complaining of a headache, Lee asked how much water she had been drinking.
“Two bottles a day,” the patient replied.
“It was 90-degree weather with high humidity, and we’d been slugging back a dozen bottles a day,” Lee said.
Dehydration was an easy diagnosis. “You look in their mouth, and their gums are dry and their tongue is dry.”
The water shortage even led to joint pains.
“People in their 80s were coming in with shoulder and neck pain. I asked if they’d been doing any lifting. They’d been carrying buckets of water — one in each hand — from a stream to their home.”
Downed power lines have their own health consequences. With no refrigeration, “Everybody on insulin had to throw it out,” Lee said.
The medical teams worked to switch those patients to oral medications.
“Anyone who was using a CPAP device for sleep apnea or a nebulizer for asthma or emphysema is out of luck. We saw many worsening severe respiratory diseases,” Lee said.
They also were able to write prescriptions for people who were mildly ill.
“Some pharmacies had started to open, so people could find some meds,” she said.
“For the severely ill, we helped get patients transferred to the USNS Comfort,” a Navy hospital ship in the bay at San Juan, or to a stateside hospital.
One of those cases involved a woman who’d had a foot amputated.
“We saw her 50 days after the surgery; we unwrapped it for the first time after the operation. It was infected and gangrene was setting in,” Lee said. “We arranged for follow-up care on the Comfort.”
But many people’s long-term health outlooks aren’t promising.
“It will take a long time to get basic services,” Simons said. “A lot of people are living on the fringe, and we will see a lot of older and chronically ill people die.”
Still another affliction is brewing, Lee added.
“The hurricane killed all the mosquitoes,” she said, but now there are reports of three serious mosquito-borne fevers: dengue, Zika and chikungunya.
“Because of the incubation periods, some team members even got fevers when they were back home,” Lee said.
Team Rubicon, their sponsoring organization, ended its Hurricane Maria response on Dec. 1. According to its website, the group deployed 229 volunteers to Puerto Rico in October and November. Its medical teams assisted 2,592 patients while other volunteers took on more than 30 recovery assignments.
Veteran-powered group
It was an interesting group to work with, the two physicians said.
“Eighty percent are ex-military,” Lee said. “They ranged from 21- and 22-year-olds to Vietnam vets in their 60s. They bring a sense of purpose, a sense of mission, and they can live in harsh environments.”
Lee said that after working with Team Rubicon, the couple wants people — particularly veterans — to know about the organization’s disaster-relief mission.
“And don’t forget about Puerto Rico,” she emphasized. “The news cycle moves so fast.”
Lee and Simons won’t be forgetting what they saw. Some of it seemed out of place, such as the tropical birds that caught his eye.
“It’s a vacation feel, in the middle of a disaster,” he said.
And some of it, Simons said, is just sad.
“People putting up Christmas decorations: A wreath was hanging on a house that has half a roof; the other half is covered with a tarp.”
