Last September, Hurricanes Irma and Maria battered Puerto Rico and the U.S. Virgin Islands, wrecking facilities, homes and essential infrastructure. Health centers responded immediately to the catastrophe, overcoming great odds to support their communities. Six months later, the regions’ twenty-three community health centers continue to play a pivotal role, providing direct care and essential community-based public health services. Yet, a new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University’s Milken Institute School of Public Health, based on a comprehensive survey, finds that health center recovery is uneven, and that while all health centers are open, many are still operating under hardship conditions.
General primary care services, medical records, and community outreach services are fully restored at all sites that provided these services before the hurricanes. But more than four in ten health centers report that specialty care services, emergency department services, and night and weekend hours were available at only some sites that offered them prior to the hurricanes. Nearly two-thirds of health centers report needing repair or replacement of their buildings, and nearly half need telephone and internet repair or replacement. And while the majority of health centers have not found it necessary to reduce services due to staffing constraints, both recruitment and retention are challenging. Health center staff are, of course, vulnerable to the local conditions and among the top challenges facing health center staff, 70 percent of the health centers report workers losing their homes and 57 percent report that staff face transportation problems and poor road conditions.
The community health centers in Puerto Rico and the U.S. Virgin Islands are a crucial part of the health care system and have demonstrated extraordinary resilience, both in the immediate aftermath and the now six months following the devastating storms. During National Public Health Week, as we champion the role of a strong public health system and advocate for healthy and fair policies, there can be no better reminder of the unique role of community health centers in improving and maintaining health. With the next hurricane season on the horizon, it’s essential that health centers in the USVI and Puerto Rico receive the support necessary to aid staff, address staffing and human resource needs, and fully rebuild.