1. Schwartz, Alicia MSN, CCM, RN

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Hurricane Maria left Puerto Rico in shambles. I was expecting destruction but it was worse than I anticipated. The trees appeared plucked gently from the ground and laid to rest. Power lines danced with the wind. Mountainside covered roads, and bridges slithered away with the river. Rooftops had floated away like helium balloons, leaving homes with an open skyline. The island no longer had its lush green color; everything was barren and dry.


We were the first to arrive-union volunteers sent by the AFT, AFL-CIO, and The Federation of Nurses UFT. We were honored to assist. Many roads were covered with piles of mud, trees, and rocks. The red clay soil, already saturated by the rain showers from Hurricane Irma, made it easy for Maria to pluck the trees like candles off a cake. One bridge was stacked with trees as if beavers were creating a dam, and I wondered if a small push would take this bridge out too. Houses on the edge of the river appeared lopsided by the river's strength, whereas others had been washed away.


We reached coastal areas. Some of these areas were hit by a 6-foot wave. Bamboo trees bent and turned into piles of round haystacks. Homes blasted from the inside out. Seaweed and metal planks lay gently on top of trees. I looked in awe and fright trying to understand the scene; imagining how Maria made a Sea God walk the Earth as it destroyed everything in its path. Water lines inside some homes marked the embrace of ocean or river. Mother Nature was on a slow, brutal, and steady wrath as she spread through the island. I saw pharmacies and medical clinics crumbled, supermarkets and grocery stores lined with empty shelves. Some stores were without light, whereas others were powered by small generators trying to conserve milk and meat that would quickly spoil.


People we visited expressed their disbelief. One lady told us how she held her front door for over 3 hours while Maria pushed. Another woman explained how she ran through the streets when the rooftop of her home blew away. A gentleman praised God for sparing his life. "My home is nothing, but I have my life." Nowhere to go, yet happy they had left their homes days before Maria made her landfall.


Many Puerto Ricans expressed anger at the U.S. government's slow response. "We are hungry," "We have no food, no water; where is FEMA, (the Federal Emergency Management Agency)?" Words were written on the streets so as to be read from the air: "HELP FOOD" or "WE NEED WATER." Servicemen said, "We served this country and this is how we are treated." Garbage cans were full. If no one gathers this waste, we knew that famine and disease would rise. Food was scarce. No electricity, so there was no place to store food. Many had no running water so they took to the rivers and streams. Pools of stagnant water surrounded their homes, attracting mosquitoes.


When people saw us they were happy, thinking we were FEMA, but then they realized who we were. We were the light to their darkness; angels without wings. We began providing care, food, water, and administering medications. We knew we would not be there for long; therefore, teaching was our priority. We have to assure they knew what to do once we left. Scabies, asthma, leptospirosis, and conjunctivitis are on the rise. Blood pressures were not controlled and elevated blood sugars were winning the battle. How could it not? People were left with only canned or processed foods. Some received junk food instead of meals. This is all they had.


We set up clinics when we could, or we knocked on doors. Our physician wrote prescriptions and decided treatment. We refilled medication bottles because pharmacies were closed. We treated uncontrolled hypertension, diabetes, skin wounds, seizures, dehydration, and fractures. Respiratory problems were due to the conditions in the homes-generators produced the smell of gasoline and mold was growing.


There was no clean running water. Water for cooking, laundry, and cleaning was being collected from the rain or rivers. The radio, newspapers, and television began providing information about a deadly disease: leptospirosis. A family we were teaching about cleaning their water informed us their uncle was hospitalized with leptospirosis and was awaiting his death. We saw many with conjunctivitis or skin fungus. Many were opting to sleep on wet mattresses as they refused to discard them. This is all they have. We taught them to place a plastic cover over the mattress but we let them know the perils of mold. Many were suffering from asthma and respiratory diseases that we treat with portable battery-operated nebulizers donated by a physician who joined our group. He provided us with donations of medications. This makes our mission much easier.

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We stopped people from taking water from rivers and springs. We taught them how to treat their water by using Clorox, aqua tabs, or just boiling their water. We educated them on how to clean their clothes and treat their skin to prevent infestation of scabies, fungus, or conjunctivitis. We taught them how to clean their homes to prevent mold and how to treat mold in their walls to prevent respiratory conditions. We reinforced the importance of removing wet items from their homes. Many were afraid to discard items because FEMA will want to see their loss. Some places had notices on walls to call a number for FEMA or use the Internet but they can't do this with no electricity or phone service. Others came by the hundreds and lined up for hours in the blazing sun to meet with a FEMA representative who sat comfortably in an office or in the coliseum under the shade. A man tells me "There is no FEMA; what we have is 'flema'" (phlegm in Spanish). Some people were hopeful and resilient, whereas others expressed there were days they wanted to "use a rope." We listened and provided them with words of hope.


We walked through streets in the mountains, climbing hills to reach people who were trapped. Our union sisters and brothers cleaned the roads. Sometimes we were escorted by the town Mayor while other times we are escorted by the National Guard, or a police escort. We knew we are safe even though the route appeared dangerous. One woman praised us for helping her paralyzed bedridden son; others cried when we left food and water at their doorsteps. Puerto Ricans are humble people. They gave us hugs, smiles and even tried to feed us. Many thanked us for our service but no thank you was needed. Some of us continue the labor after returning home, sending clothes, solar light, water filters, or medication. We continue to raise awareness and be the voice for Puerto Rico. These U.S. citizens were left for days without assistance and union workers heard the calling. We may not have been in the eye of Hurricane Maria but we were in the eye of the storm.