In Puerto Rico, a new hurricane season threatens the elderly

[June 14, 2018]  By Nick Brown, Jessica Resnick-Ault and Ricardo Ortiz

ADJUNTAS, PUERTO RICO (Reuters) - At 84 years old and battling cancer, Israel Gonzalez Maldonado has lived without electricity for the nine months since Hurricanes Irma and Maria devastated Puerto Rico.

His wife, Zoraida Reyes, 77, struggles to keep the house stocked with fresh food without a refrigerator. At night, she fans her husband so he can sleep.

With another hurricane season starting, older Puerto Ricans have little to protect them from another storm on an impoverished island that remains far from fully recovered. Younger and wealthier people have been moving away for years, leaving an older and sicker population in the hands of an underfunded healthcare system. Tens of thousands more have fled since Maria.

“We wish we could move, at least for the time he has left,” Reyes said of her husband.

Senior citizens make up a larger share of the population here than in all but four U.S. states, according to federal Census data. About half are disabled, more than any state.

Forty percent of seniors rely on food stamps, more than three times the percentage in New York state, the second-highest nationally.

(For a graphic on Puerto Rico's aging population, see: https://tmsnrt.rs/2L9N6M0 )

Yet the island has just six nursing homes - with a total of 159 beds - that are certified by the U.S. Centers for Medicare & Medicaid (CMS) to provide rehabilitative services.

Puerto Rico relies instead on a patchwork of about 800 nursing homes licensed by the island's Department of Family. They are typically private businesses or nonprofit organizations that care for small numbers of elderly people with limited services - and limited budgets, strained further since Maria.

A fragile healthcare system is hardly the only problem that leaves the elderly here - and all Puerto Ricans - vulnerable to another catastrophic storm.

About 7,000 houses and businesses still lack power, after Maria leveled a grid that was ill-maintained before the storm. Power utility PREPA has patched together most of the system but remains years away from making the fundamental improvements needed to enable it to withstand another hurricane.

An elderly woman prays at a chapel of the San Rafael nursing home in Arecibo, Puerto Rico February 14, 2018. Picture taken February 14, 2018. REUTERS/Alvin Baez

"The grid needs to be rebuilt - not just the lines," PREPA Chief Executive Walter Higgins said.

Maria also damaged nearly half the island’s levees. Several major water pumps, used to remove floodwater, remain in disrepair.

“God help us, but we definitely can’t handle any more hurricanes,” said Tania Vazquez, the island's secretary of natural resources.

Governor Ricardo Rossello’s office declined to comment on the island's hurricane preparedness or on specific efforts to protect the elderly, referring questions to other agencies.

Glorimar Andujar, Secretary of the Department of Family, said officials learned a lot from Maria about how to prepare for the next storm.

“The emergency plans are much better," Andujar said, "because we now have an experience that no other generation of agency leaders have experienced.”

ELDERLY AT RISK

Rosa Iturrizaga runs Hostal de Amigos, a small eldercare residence in San Juan.

The home barely broke even before Maria, relying on resident fees of between $2,000 and $3,000 a month. Since then, two of 11 residents moved to the mainland, and insurance has so far not paid for about $40,000 in storm damage, Iturrizaga said. The business carries $500,000 in debt, has fallen behind on loan and tax payments and now loses up to $5,000 a month.

"I don't know what's kept me going," Iturrizaga said. "I love doing this, but I'm looking at other things to do with the land."

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