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 The donations - tens of thousands of intrauterine devices and birth
control pill packs - came from major healthcare companies as the
virus spreads rapidly through the island.
The delivery delays illustrate the struggles of Puerto Rico’s
healthcare system, which is faltering amid the commonwealth's
financial crisis.
Hundreds of thousands of residents are expected to be infected in
the coming months by the mosquito-borne Zika virus. Infections in
pregnant women can cause microcephaly, a rare birth defect that can
lead to severe developmental problems.
Many local doctors do not have the expertise to insert IUDs, and
have not stocked them because of their high cost to patients.
The CDC Foundation, the U.S. public health agency's philanthropic
arm that received the donations, said it needs $20 million for
training and follow-up services to get the contraceptives to women.
“We have people who would love to have them available,” said Dr.
Carmen D. Zorrilla, professor of Obstetrics and Gynecology at the
University of Puerto Rico School of Medicine. She is encouraging
patients to wait at least a year to get pregnant.
As many as 138,000 women on the island are at risk of unintended
pregnancy, based on historical trends and a lack of access to
contraceptives, according to the U.S. Centers for Disease Control
and Prevention.
Bayer AG, Allergan, Medicines360, Upstream USA and Merck have
together contributed about 60,000 IUDs and 80,000 packs of birth
control pills in recent weeks. The CDC estimates that about a
quarter of Puerto Rico’s 3.5 million people could be infected with
the virus.
Dr. Judith Monroe, President and CEO of the CDC Foundation, said the
organization has trained about two dozen doctors and raised about
$1.7 million in cash, enough to provide 700 women free services
starting in June. It needs to raise an additional $20 million to
train and pay medical professionals who will provide the services.
In the meantime, the companies are still holding the donated devices
and pills while the CDC Foundation lines up a licensed distributor
in Puerto Rico.
At the behest of the CDC, the nonprofit in February began soliciting
private sector donations for Puerto Rico, Monroe said in an
interview. Raising extra money for contraceptive distribution was
challenging as would-be donors may not yet grasp the urgency of the
situation in Puerto Rico.
"We have an opportunity to be innovative," she said, referring to
increasing access to "family planning across Puerto Rico, services
that have not been there before on this scale."
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DOCTORS UNDER FINANCIAL STRESS
Money is essential to train and pay medical professionals, many of
whom are barely surviving because of the island's financial crisis
and historically low reimbursement rates from the U.S. government's
Medicaid insurance program for the poor, which covers nearly half of
residents.
"It is hard, close to impossible to ask doctors to take anything
else from their pockets," said Dr. Nabal Jose Bracero, who chairs
the Puerto Rico section of the American College of Obstetricians and
Gynecologists. "Things are very, very rough."
The current Zika outbreak was first detected last year in Brazil and
has been linked to more than 1,400 cases of microcephaly. It has
since spread to at least 39 countries and territories in the
Americas. In Puerto Rico, at least 1,726 cases of Zika infection
have been confirmed, including in 191 pregnant women, according to
the Puerto Rico health department.
Zika is expected to arrive in the continental United States in the
coming weeks as the weather warms. CDC officials expect that Puerto
Rico will be hit harder given the prevalence of mosquitoes that
carry the Zika virus on the island and a lack of infrastructure to
protect against the insect bites.
Health care donors say they are now urgently focused contraceptive
distribution.
"We are working with the CDC Foundation on the distribution
arrangements to ensure that product gets to Puerto Rico as quickly
as possible," said Gavin Corcoran, Chief Medical Officer at Allergan.
Bayer, Allergan and Medicines360 also have begun training a few
dozen medical professionals to use their IUD devices, which need to
be inserted and removed by a person with expertise to avoid
potentially serious complications.
Despite the difficulties of distribution, Bracero said health
professional in Puerto Rico are grateful for the contraceptive
donations.
"It’s overwhelming," he said, "one of the good things to come out of
the horrible situation."
(Reporting By Jilian Mincer; Editing by Michele Gershberg and Brian
Thevenot)
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