Puerto Rican general explains military strategy for health services
SAN JUAN — Under normal circumstances, Puerto Rico has 69 hospitals. In the island’s new reality after the impact of Hurricane María 16 days ago, the island has 63 “functional” hospitals; 45 are operating with electric generators and, of these six require special care, while 24 already have service from the Puerto Rico Electric Power Authority (Prepa).
Dual Status Commander José Reyes, Brigadier General and Deputy General under Three-Star Gen. Jeffrey Buchanan, explained that to be considered “functional,” a hospital must have surgical rooms and be able to attend to the immediate needs of surgical patients, including operative and postoperative treatment, even if power is being supplied by a generator.
If the hospital loses its power source, it ceases to be operational, so it is necessary to have a contingency plan to deal with that situation should it occur. For that, the USNS Comfort, a hospital ship with four operating rooms and the capacity for approximately 1,000 patients, is currently sailing along the Puerto Rican coast.
With the support of Comfort, the Puerto Rico and U.S. Health departments are in a better position to identify those patients who are in critical condition and require more direct care, in order to transport them to the ship.
Moreover, according to Reyes, the military’s priority is to ensure diesel distribution to health institutions and to supply essential items for their operations. To achieve this, a diesel supply line was established for the 69 hospitals, with of support medical units from the National Guard of Puerto Rico that were assigned “liason officers” to work hand in hand with hospital administrators .
“Because they speak the same medical language, they can address their needs and channel them to our operational center. Needs like supplying diesel, medicine and transferring patients to military medical hospitals,” said the Puerto Rican general.
Additionally, in the southeastern region of the island, where the eye of the hurricane entered, federal authorities will establish what is known as a Combat Support Hospital (CSH), a mobile hospital with two operating rooms and 44 beds. The advantage, he added, is the flexibility they provide since “once we cover the needs of that area in Ceiba, Humacao and Naguabo, we can relocate it.”
The CSH covers almost five acres of land and setting it up required the authorization of the municipality of Humacao. The CSH is expected to be installed early next week. Like the Humacao CSH, one will be established in Aguadilla. They haven’t ruled out placing the Comfort in Ceiba and eventually moving it to the port of Ponce, “we will move it according to priorities and as needs are assessed,” he said.
Meanwhile, as part of the contingency plan, military and state officials give daily maintenance to the power generators, which are typically meant to be used for hours, not days, weeks or months.
Regarding medicines and other hospital necessities, Reyes said there was a need to open air and sea ports to “lift” the containers. “They have already lifted over 900 (shipping containers), and that flow of medicines, of essential items, is beginning to be restored,” he stated.
Department of Defense forces, including the active Army and the National Guard along with the Puerto Rico and U.S. Health departments, are making assessments to establish a contingency plan.
Reyes said that the immediate contingency plan was to bring the ship to the island, “which gives us the ability to attack those needs, possible infections that may arise from the ravages of the hurricane. They are in the process of establishing contingency plans and identifying what their medical needs are; experts in the field identify them, we accept them,” he said.
In addition, this working group will be responsible for identifying possible health risks after the hurricane and how to isolate them. He said that so far no outbreaks have been identified, although there are typical ones that can occur, such as conjunctivitis.