In post-Fiona Puerto Rico, rural healthcare inequalities become apparent

On September 17, Hurricane Fiona hit Puerto Rico, causing destruction and taking out the electricity grid. As expected, the residents of Puerto Rico quickly switched to generators running on diesel. However, access to diesel was disproportionate. Big hospitals were prioritized over community health centers, even though the latter often had more patients in dire need of care. This significantly impacted the people who rely on these health centers. 

Residents in rural areas were harmed because they didn’t have access to a hospital and could not get the treatment they needed from health centers due to the lack of diesel. Diesel was needed in these health centers to power ventilators, refrigerate vaccinations and medications, operate equipment, and assist with other essential medical procedures. 

These health centers in Puerto Rico are sanctioned through the Public Health Service Act and are nonprofits that provide medical care regardless of a patient’s financial situation. Many Puerto Ricans outside big cities rely on health centers due to a lack of hospitals in these areas. 

According to Professor Jennifer Carlson, the decision to prioritize big hospitals was likely made because it was believed to be the best way to save lives and protect property. Community health center workers are worried that the mistakes will repeat themselves during the next natural disaster. In addition to the diesel shortage, generators were not able to handle the long hours. Most generators on the island were designed for powering centers for a few hours, and 24 hours took a toll on their efficiency. 

In order to be more prepared, health centers in Puerto Rico are expanding their diesel storage capacity to be able to hold more diesel for emergency use. Many people are pushing for infrastructure changes, noting that these centers need to be considered critical infrastructure. Alicia Suárez, executive director of the Association of Primary Health of Puerto Rico, stated that health centers are necessary because they not only offer healthcare to underprivileged communities, but they also prevent hospitals from filling up. It would be in the government’s best interests to ensure that hospitals and health centers receive equal resources in the next emergency situation.