4,645 or 64- Does it really matter today?

A recent Harvard study published in the New England Journal of Medicine[1] estimated that death toll of Hurricane Maria in Puerto Rico exceeds 4,645.[2] The Puerto Rico government’s official figure stands at 64.

Behind the government’s underreporting of casualties there is a more serious inquiry: Who is to blame for the additional deaths included in the Harvard study? Was it the storm or the government’s inability to deal with the emergency and the turmoil that followed during the months thereafter?

Politicians on both sides of the spectrum are pointing fingers, trying to take advantage of the visceral opinions everyone has on the matter, with the purpose of escalating the debate.

The study’s conclusions cannot be swept under a rug. They provide an ominous hint of a bigger problem that is not being told. A situation that cannot be ignored, for its repercussions will prove to be more devastating than what the Harvard researchers concluded.

To wit: that the number of deaths actually exceed the researchers’ estimates. Furthermore, it would establish that if the government does not implement urgent precautionary measures, additional deaths that will never be associated with the storm will inevitably continue to occur.

Take, for example, my Old San Juan neighbor Carlos. He was a great man that brought a lot of happiness to many. He died as a result of health complications that he developed as a result of the lack of electricity and clean water for weeks after the hurricane.

Carlos survived on what he earned playing his guitar, singing a capella in a plaza in front of the San Juan Cathedral. Had he been born in Rome, I am certain he would have probably sung next to Pavarotti in some stage.

A tourist that could appreciate what a gift Carlos had, uploaded to YouTube a full song by him. A true gem.

Carlos was always in good spirits — smiling and cracking jokes. Whenever there was a power outage, he would sit on a chair in the balcony of the building he lived in and sang. With his formidable voice that filled the whole street, he would report from his balcony: “If there is nothing else to do, I might as well sing.”

One of his favorite songs — which I was lucky enough to film from my balcony once — was “En mi Viejo San Juan”. “In my Old San Juan” — a hymn that evokes the deepest sense of nostalgia and brings tears to the eyes of any Puerto Rican, regardless of their creed. Tears that become rivers on a lonely Christmas night in a -10°F weather in NYC.

When Carlos sang, passers-by would stop in front of his balcony and join him in unison.

After the hurricane, Old San Juan did not have power for months. The heat was unbearable.

Carlos hung a hammock from his balcony to sleep at night and made a makeshift tent to shelter himself from the rain and the morning sun. It took him a while to perfect his invention. I would see him at the hardware store buying materials to improve his contraption.

He slept there every night and never did I once hear him complain.

Weeks of sleeping on a hammock caused Carlos to develop a severe spinal cord pain that forced him into the hospital. After his release, the area on his arm where the IV had been inserted got infected.

Clean water was scarce in Old San Juan for months after the storm. Carlos developed a bacterial infection from his iv wound that spread to his body. Unable to fight it off, he passed away on December 1st.

Electricity was restored in his building on December 6th.

I drafted a simple translation of part of the song Carlos sang that afternoon from his balcony.

In my Old San Juan

How many dreams I made up

During my childhood

My first hopes

My heartbreaks

Are soul memories

One afternoon I parted

to that unknown nation

Because destiny so had it

But my heart remained

in front of the ocean

In my Old San Juan.

Carlos’ heart remained in Old San Juan. It is within the heart of many of us and those who listened to his beautiful voice.

While the storm itself did not kill Carlos, I hold no doubt its aftermath did.

He did not have to die.

It is unlikely Carlos will figure as one of dead that the government failed to count. He probably is not even in the Harvard study’s charts.

I think Carlos should figure in the statistics. The lack of electricity and clean water for such a long period of time created the chain of events that culminated in a sudden, unforgiving illness that silenced Carlos’ voice. That is why I believe that the study probably underestimates the actual amount of deaths that occurred and continue to occur as a result of the storm.

There are still thousands of people without electricity. Many of them elderlies in retirement homes.

Mental health is not being adequately addressed by anyone. PTSD, depression and anxiety are currently prevalent in all of Puerto Rico. It is no secret that these emotional conditions are known to directly impact heart and immunodeficiency diseases. They will continue to cause or accelerate deaths.

Instead of pointing fingers at each other, the authorities should be concentrating on preventing additional deaths in the future.

That is what really matters today.

[1] https://www.nejm.org/doi/full/10.1056/NEJMsa1803972

[2] In fact, the study’s conclusions are probably on the conservative side since it does not seem to take into account the increase in suicides that resulted from the storm. In Puerto Rico, for the year 2017 there were 57 more suicide deaths than in 2016. Mental health professionals attribute the increase to the storm. http://www.galenusrevista.com/La-salud-mental-en-Puerto-Rico.html



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Ana Toledo

Ana Toledo

Puerto Rican warrior & targeted individual; fighting for equal environmental rights, one pipe at a time”. “Mi nada, a nadie se lo debo.” Julia de Burgos.