Seniors in Puerto Rico Face Appalling Conditions After Hurricane Maria

Heida Stearns Rivera, 81, lives in Vieques, an island municipality off Puerto Rico's eastern coast. Three weeks after Hurricane Maria's impact and destruction, she is still struggling. Older adults like her are among the most vulnerable to ongoing shortages of fresh food, medical care, prescription drugs, sanitation services, transportation, ice and electricity.

Fortunately for Stearns Rivera, her son, Paul Stearns, originally visiting Puerto Rico to attend a festival, learned of advance warnings of Maria's building magnitude from the Federal Emergency Management Agency. Stearns, a former communications director with the Gerontological Society of America, was there when the storm hit.

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With cell service still spotty, text messaging was the only way Stearns could participate in an interview with U.S. News to share his concerns over the plight of seniors. On Sunday, he got a call through but reception was poor. However, phrases such as "bad day today," "actual chaos," "frustrating" and "disorganization with multiple organizations" were audible. He noted a lack of coordination in efforts to distribute food and water.

Excerpted below is a series of texts sent between Friday, Oct. 6 and Monday, Oct. 9 by Stearns from Vieques, describing his mother's personal situation and island deprivations.

Seniors must fend for themselves in unsanitary conditions, Stearns reports:

If I was not here, it would be hard for my mother to manage, such as daily tasks of finding ice to keep food fresh since there is no electricity, managing a cistern to flush the toilet and keep dishes clean when there is currently no running water.

Her home received damage from two sliding doors that imploded during the storm. We had water entering the home and obviously broken glass. Mom was unhurt but terrified by the sound of crashing glass and the howling wind that was coming in during the height of the storm.

I have relatives that have homes that will probably be a total loss because of the type of construction. One [relative] is a 71-year-old living in the home. We were lucky to have a home built 100 percent of concrete.

Since the storm I am surprised [at not seeing] any special attention being given to older adults and other vulnerable populations here on the island.

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Ice and water are limited -- and following a FEMA advisory to boil drinking water is easier said than done:

We are eating and [the] grocery store is open but [with] limited options for a healthy and balanced diet. Fresh vegetables have been nonexistent and [we] mostly count on canned foods. Our home and many others have electric stoves so it is difficult for me to make a balanced meal for her. I am currently using a single Sterno with a hibachi grill supported by two cans of corned beef. I have a camping stove that uses small propane tanks but I am no longer able to find them.

Every day I have to hunt and gather ice so we can have cold water and fresh milk. That requires me to drive, many days, about two miles out of town to the local ice plant, which was damaged after Maria but was repaired within about eight days. There is no ice provided to older adults. I am paying $2 per bag and require about three but sometimes we can only get two bags per person that are present.

Medications are hard to come by:

For 81, my mom is in fairly good health and only suffers from hypertension, cataracts, glaucoma and two stiff knees from past knee replacements. She does have a problem with mobility and requires a cane for support.

[It's] very hard for an older adult who may live far from the main town to know what is happening or how you can get services. After the storm there were people who could not get medicine such as insulin and inhalers because they had no cash. The pharmacy refused and it took a local hotel to front the cash. We are an all-cash society now.

My mom refilled her [prescriptions] after the storm and waited over an hour to get them but only after waiting outdoors in the sun for two hours to get cash from the bank, after proving she had a recurring deposit from Social Security and her retirement.

Health care access is uncertain:

For those who are not able to leave their homes, medical care needs to be brought to them. Having a health clinic in the plaza of the main town is great but one has to know about it and be mobile to get there.

On the day Maria arrived landline phone service was cut and we had no way to dial 911 and still don't since cellphone service doesn't reach every part of the island. About a week ago we had a lady who became ill in front of our house and someone had to find emergency assistance.

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His mother strives to stay positive, but emotional fallout is inevitable:

There have been some tough days where she has been down and even cried when an orange juice bottle burst when contents went bad and pressure built up. I noticed she now prays every day and says the rosary. Catholicism runs deep here on the island.

I am worried she may become depressed after going back to the States and she leaves family, friends and other acquaintances behind. Her home has a large front porch with people passing by all day, she will lose that when she returns with me to my house.

Lack of electricity persists:

Some people have already left and more are planning to leave until the electrical infrastructure has returned. ... It is hard for [my mother] to get a good night's rest without [air conditioning] and some days she is overly hot. There are no temporary cooling areas for older adults to go to.

Another bit of unwelcome news for the senior population:

Sadly, I was told that the local senior center is a loss after Maria. Vieques is an island of approximately 9,000 residents. Thirty-five percent are 65-plus and I have heard we have a centenarian on the island.

Residents rely on one another:

A neighbor who has a gas stove will offer her some hot meals, such as rice and beans, arepas, bacalaítos and other local food. I will get them and buy ice for [the neighbor's household] since they have no transportation. The neighbor is an older woman with multiple chronic health conditions. I also will get ice for my cousin's wife who is here from the main island caring for her 88-year-old father. It is people taking care of people the best way we can with what we have.

One other item I'd like to add is with older adults and their pets: The Humane Society is here and I volunteered with them yesterday. I asked what was specifically being done to help these older adults with pets. There seems to be [nothing].

So much more I have seen it is hard to believe that this is 2017. Moreover, I am appalled at the lack of government response from our U.S. government and Puerto Rico. The cleanup effort has been by the people of Vieques.

Lisa Esposito is a Patient Advice reporter at U.S. News. She covers health conditions, drawing on experience as an RN in oncology and other areas and as a research coordinator at the National Institutes of Health. Esposito previously reported on health care with Gannett, and she received her journalism master's degree at Georgetown University. You can follow her on Twitter, connect with her on LinkedIn or email her at lesposito@usnews.com.