ABOVE: Hurricane Maria damaged the door of AIDS Healthcare Foundation’s clinic that had been under construction in Trujillo Alto, Puerto Rico. Puerto Ricans with HIV/AIDS remain vulnerable three years after the hurricane devastated the U.S. commonwealth. (Washington Blade photo by Michael K. Lavers)
Ricky Martin a few days ago shared on his official Instagram account an image with former Vice President Joe Biden where he promoted the Democratic presidential candidate’s plan for Puerto Rico. The message coincided with the third-year mark of Hurricane Maria’s devastating landfall in the U.S. commonwealth.
“Biden will ensure that Puerto Rico will receive urgently needed federal disaster reconstruction funds to support Puerto Rico’s long-term recovery and increase its ability to withstand future storms,” Martin wrote.
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The ravages of Maria continue to be felt among the Puerto Rican people, and remain visible in the island’s infrastructure.
The New England Journal of Medicine estimates Maria killed 4,645 people in Puerto Rico. The hurricane also left the entire island in darkness and 60% of the population without water. Maria caused an estimated $100 billion in economic losses that set Puerto Rico back 40 years.
A study conducted by the University of Puerto Rico’s Medical Sciences Campus and Columbia University notes Puerto Ricans living with HIV/AIDS were one of the groups that Maria impacted the most.
The study notes viral suppression decreased from 71% to 65% in the entire sample as a result of Maria’s impact. Access to medical assistance and health services for these patients fell by more than 2%.
Puerto Rico has one of the highest HIV/AIDS infection rates in the U.S.
A total of 48,506 people have been diagnosed with HIV in Puerto Rico from Jan. 1, 1981, to June 30, 2017. The coronavirus pandemic has raised the figure to 50,163 cases, according to data from the University of Puerto Rico’s Medical Sciences Campus’ Integrated Clinical Trials Unit.
Puerto Ricans with HIV/AIDS, however, were vulnerable before Maria due to a combination of factors that include a lack of resources to combat the epidemic and the island’s debt crisis. The slow pace of recovery from Maria, combined with the coronavirus pandemic, has left the outlook for this population much more complex.
‘Still a long way to go’
Wilfred Labiosa, executive director of Waves Ahead and SAGE Puerto Rico, will never forget the family he visited a few days after Maria. The strong winds had blown the roof of their home and ripped it to pieces while they took refuge on the first floor.
He went there to provide food, water and basic necessities, which he distributed in 28 municipalities.
“People living with HIV/AIDS did not have their necessary medicines or meals,” recalled Labiosa. “The municipality of San Juan and the VIDA Clinic (a clinic the municipality of San Juan operates) helped a lot in this need.”
Several other NGOs extended a helping hand to help those who lost everything to nature’s impetuous force. One of them, AIDS Healthcare Foundation, sent a cargo plane from Miami with 50 electric generators to help restore power to the Puerto Rico Department of Health’s facilities.
Silvana Erbstein, regional director of AIDS Healthcare Foundation in Miami-Dade County and Puerto Rico, says local agencies in Puerto Rico were not prepared to face an event of this magnitude.
“A large part of the patients with HIV/AIDS were affected by the interruption of their treatment, the limited availability of clinical care, lack of access to essential services, and the difficulty to receive medicines due to the lack of electricity, water, reduced hours or inaccessibility,” Erbstein explained. “Despite the emergency, the AHF Clinic in Trujillo Alto, Puerto Rico, continued with its operations providing medical services and medicines thanks to its Crisis Management Plan.”
Labiosa described the Island of Enchantment’s recovery three years later as slow, costly and traumatic.
“[It has been] costly because members of the central government and in some cases municipalities have stolen the financial aid we have received for their personal purposes; they have divided the money between friends, giving multimillion dollar contracts without experience or results; traumatic because people have had to ‘look for it’ and as soon as they think they are afloat another situation comes,” Labiosa told the Washington Blade. “We have been able to survive so many things and now COVID-19.”
Waves Ahead has been able to rebuild 21 homes thorough its ReconstruyeQ project.
Labiosa says his organizations are now helping Puerto Ricans weather the pandemic. They have been able to provide gloves, soap, masks and meals to 1,045 people.
“Non-profit organizations like us and private entities make a difference and help more than the government itself,” says Labiosa.
Anselmo Fonseca, president and founder of Pacientes de SIDA Pro Política Sana, a Puerto Rican HIV/AIDS service organization, agrees.
“Most, if not all, of the work is left to NGOs to provide it from the heart, without pay,” he said. “The government is so full of corruption cases in practically all the agencies, since this administration.”
The Trump administration on Sept. 19 announced $13 billion in aid to rebuild Puerto Rico’s power grid and other infrastructure that Maria damaged or destroyed. This announcement comes after the White House faced scathing criticism over its response to the hurricane.
Puerto Rico Resident Commissioner Jennifer González Colón, who is a Republican, in an email interview with the Blade acknowledged Congress has authorized funds for Puerto Rico in response to Maria and Hurricane Irma that brushed the island in early September 2017.
“Although the disbursement of these funds has not occurred with the haste that the seriousness of the situation required, the truth is that the recovery of Puerto Rico is under way,” said González.
González noted to the Blade she continues to support the LGBTQ community.
She pointed out she has co-sponsored the Equality Act and several other LGBTQ rights bills in Congress. González is also the co-chair of the Congressional HIV/AIDS Caucus.
González noted Puerto Rico’s infrastructure was already quite fragile before the hurricanes hit it in 2017, so “there is still a long way to go, but Puerto Rico’s recovery is undoubtedly on track.”
Fonseca said many Puerto Ricans continue to suffer from severe post-traumatic stress disorder three years after Maria. He said his organization continues to provide them with emotional support, apart from access to a housing program and health clinics.
With the arrival of the coronavirus a few months ago, the situation has heightened concerns among patients with HIV/AIDS because the pandemic has once again caused interruptions in medical and pharmaceutical services.
“Most HIV patients are served by government agencies or small local non-profit agencies, many of them unprepared and without sufficient protective material and equipment available,” said Erbstein.
She added that AIDS Healthcare Foundation has kept its doors open during this pandemic, ensuring any person with HIV can access medical services and can receive their medicines on time.
González told the Blade she was able to secure an additional allocation of almost $2 million in federal funds through the Ryan White Program under the federal CARES Act in April. These funds will benefit the San Juan Department of Health, public and private organizations and other programs and institutions.
“These last few months have been tough for many living with HIV/AIDS,” added Labiosa. “Jobs have been lost, clinics closed … We are also entering another hurricane season and now with COVID doing the most difficult preparation and recovery tasks.”
Labiosa said shelters open with less capacity due to physical distancing. He added organizations and families have to spend more on basic items to face the global health epidemic.
“Since there is no money, people are more exposed by visiting pharmacies and supermarkets daily, since they go dollar for dollar every day,” said Labiosa. “The recovery of houses is much slower in these months of the hurricane season, since the rains prevent construction. It is sad what is happening in Puerto Rico, but we are resilient and we are going to overcome this.”
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