Sarah Varney, Kaiser Health News
SAN JUAN, Puerto Rico — Straddled throughout Ausberto Maldonado’s yard in Bayamon, a suburb of San Juan, is a nagging reminder of Hurricane Maria’s damaging energy.
“See, that tree broke off that branch, which is as thick as a tree — and now it’s in my yard,” mentioned Maldonado, a 65-year-old retiree.
The downed tree — and the rats interested in it —stop Maldonado from hanging his laundry. To get the tree eliminated, he should present up at a neighborhood authorities workplace. But the diabetic ulcers on his toes make it painful for him to stroll.
After a lifetime of labor on the U.S. mainland, selecting corn and asparagus and processing chickens in poultry crops, Maldonado returned to Puerto Rico a decade in the past to assist take care of his ailing mom, who has since died. Today the retiree finds himself dwelling day after day on the island. He receives $280 a month in Social Security and $89 a month in meals stamps — which alone covers about $Three a day for meals.
Six months after Hurricane Maria devastated Puerto Rico and its financial system — and killing by some estimates at least 1,052 people — the every day indignities are piling up, particularly for people who find themselves frail or aged. Many are discovering their present financial straits practically as threatening because the storm.
The storm additionally crippled the island’s energy grid, and as of Sunday 86,000 utility prospects nonetheless had no electrical energy of their houses and companies, affecting lots of of 1000’s of individuals.
In the island’s central mountain area, complete cities and neighborhoods proceed to depend on finicky and costly gas-fueled mills, placing the aged and chronically in poor health who rely upon ventilators and sleep apnea machines in danger. Many houses alongside the island’s mountainous roads stay totally at nighttime and do not need clear water.
The emergency authorities help that helped pay for some well being care companies and medically associated transportation wants of Puerto Ricans after Hurricane Maria is operating out. Private donations of water and meals have slowed. And it’s not clear who, if anybody, will keep on with that work.
Maldonado opened the cabinets in his tidy kitchen. There are a number of cans of corned beef, SpaghettiOs and beans. He sounds wistful about what he likes to cook dinner.
“When I have enough food, when I do my groceries,” he mentioned, “I have eggs and bread and coffee and juice for breakfast. I would make spaghetti or some sort of salad and maybe a little dessert” for dinner.
But the oven is unplugged, and there’s no juice or eggs or lettuce. It has been months, Maldonado mentioned, since he has had recent greens in the home.
“When there’s very little, then I kinda go on a diet,” he mentioned.
It was arduous sufficient for the retiree to fill his cabinets earlier than the storm, however now, as many assist teams are winding down their donations, Maldonado wants to seek out cash to purchase clear, bottled water and to exchange his fridge, which was ruined through the hurricane.
To purchase groceries, he should wait two weeks for his subsequent Social Security examine.
“I’m waiting until the 10th so I can go do my grocery shopping again — if I can find a way to get there,” Maldonado mentioned. “That’s when I would have food again, enough to make three meals — lunch, breakfast and dinner.”
Maintaining a good weight-reduction plan isn’t merely about staving off starvation; diabetes is consuming Maldonado’s foot, and except he eats wholesome meals and takes his insulin, medical doctors have warned him, his foot will must be amputated.
Maldonado opens the door to his damaged fridge and factors to a vial that holds a number of drops of insulin — the final of his provides till he can afford the $Three copay for refills and discover a trip to the pharmacy.
“The pharmacist said it could be stored in a dark place [without refrigeration] for a couple of weeks,” he mentioned.
Ideally, insulin ought to be saved cool, however damaged fridges and an absence of energy in lots of houses in Puerto Rico pose grim hazards for the island’s increasing inhabitants of individuals with diabetes.
A visiting nurse, Leslie Robles, who checks on Maldonado month-to-month, examined the Three-inch-long, gaping wound on his foot. They sat on the kitchen desk underneath a print of Leonardo da Vinci’s “The Last Supper” and sifted by means of piles of paperwork for Maldonado’s upcoming cataract surgical procedure.
Robles instructed him that the free medical transportation service the federal government made accessible to giant numbers of individuals after the storm is expiring quickly, and he’ll not qualify without cost rides.
But she doesn’t inform him the visiting nurse program she works for, operated by VarMed, a well being care administration firm whose companies had been paid for by the federal government, is shutting down, too.
VarMed has been serving to coordinate medical care, social companies and housing for 1000’s of Puerto Ricans for 4 years. The firm, in current weeks, laid off greater than 100 nurses and social staff throughout the island, because the native authorities seeks to overtake its Medicaid contract with insurance coverage corporations.
It is unclear how for much longer Robles will be capable of assist Maldonado, and different sufferers like him, who’re on Medicaid and have advanced medical wants — the “high cost, high need” sufferers on the island.
The authorities desires Medicaid-contracted insurers to develop their very own applications for these sufferers, however the earliest that might occur is that this fall.
In the meantime, Maldonado mentioned he has nobody to assist him store for groceries, fill prescriptions and get to physician’s appointments; the volunteers who helped him survive Hurricane Maria are returning to their very own lives.
In some ways, he, too, is returning to the identical spartan life he had earlier than the storm. But with a weakened island security web that continues to unravel, and along with his personal well being more and more tenuous, Maldonado mentioned he feels alone.
Kaiser Health News (KHN) is a nationwide well being coverage information service. It is an editorially impartial program of the Henry J. Kaiser Family Foundation which isn’t affiliated with Kaiser Permanente.