The difference between 4,645 and 64 deceased in the aftermath of Hurricane María is… science

June 1, 2018 | 3:30 pm
Juan Declet-Barreto
Senior Social Scientist for Climate Vulnerability

Over the last few decades, we have seen the Puerto Rican populace’s vulnerability to extreme weather hazards increase as the built environment and social services infrastructure decays, Puerto Ricans and their families flee at an increasing tempo to the United States, and the frequency and intensity of hurricanes in the Caribbean increases. Growing up in Puerto Rico, I lived through one hurricane (Hugo, 1989) and a few tropical storms, but nothing compared in ferocity and devastation to Hurricanes Irma and María.

Given the destruction and flooding from these two hurricanes, the ineptitude of the Puerto Rican government in handling the situation, and the unwillingness of the Trump administration to adequately assist the citizens of its territory, it was hard to believe that the death count had only reached 64 fatalities, as Puerto Rican Governor Ricardo Rosselló’sDepartment of Public Safety claims. In fact, Puerto Rican society widely mocked the government’s numbers and suspected either incompetence or a deliberate undercount to minimize the magnitude of human toll.

A new study offers evidence of what Puerto Rican communities suspected. Independent researchers at Harvard University estimatedthat at least 4,645 people lost their lives in the aftermath of Hurricane María, with one-third attributed to interrupted or delayed health care. The researchers used household surveys to calculate an all-cause mortality rate after the hurricane, and compared this rate to official 2016 (i.e., pre-María) mortality rates to estimate excess deaths from the hurricane. That number is supported by the researchers’ methods and data, but it is also symbolic, as it represents the central estimate of between793 and 8,498 deaths. For perspective, and to underscore that Puerto Ricans experienced a real catastrophe (contraTrump’s false assertions that I debunkedhere) 4,645 ismore than those killed by the terrible calamities of 9/11 and Hurricane Katrina.

Among the statistical estimate of 4,645 we can count real people

Who were these thousands of people who lost their lives after the hurricane? We will likely never know for sure, but among them wasGaspar Cruz Agosto, a 73 year-old Puerto Rican man who was scheduled for surgery before the hurricane, but who could not be operated on because the hospital lost power after María. Mr. Cruz Agosto died two weeks after the hurricane because the hospital could not provide him with the critical care he needed. This sad case does not appear to be isolated, as Puerto Rico’s independent Center for Investigative Journalism (CPIin Spanish) estimates that60 percent of María-related fatalities ocurred in health care or retirement home facilities.

The difference between the official count and the estimate is vast—it is, in fact, more than 70 times the official figure. What can be the cause of the enormous discrepancy? Well, it’s clear that the answer is…science. The large undercounts appear to be due to established protocols that require that a medical doctor annotate a death certificate linking the clinical cause of death to the disaster event.As CPI explains,attending physician in these cases is seldom the physician certifying the death of a patient. This means typically there was no contextual information included in a death certificate—information like lack of electricity, transportation services, or medicines, interrupted health care, dietary changes, temperature increases, or stress caused by the disaster. If we add to that the chaotic conditions after the hurricane, and the lack of communication with public health agencies, hospitals, and funerary homes, it becomes clear that obtaining an accurate count of fatalities was a very difficult task.

But the disaster conditions and the inadequacy of death certificate protocols in Puerto Rico do not excuse the Rosselló administration’s attempt to discourage at least two prominent Democratic senators from要求国土安全部ensure an accurate count of all storm-related deaths. ThePuerto Rican government’s lobbyistwho called Democratic congressional offices suggested that focusing on the death toll would negatively impact the image of Governor Rosselló, showing more concern for public relations fallout than for the well-being of our people. Didn’t we just see a similar disregard for human health and concern about a “public relations nightmare” in the Trump administration’s blocking of a study on hazardous chemicals on military bases in the U.S.?

Arguably, thelack of attention and resources given to Puerto Rico by the Trump administrationalso had a role in increasing the death count, as the President’s disparaging and dismissive tweets about Puerto Ricans and the disaster likely sent the message to all levels of the federal government that neither he nor his agencies should be very concerned about the plight of Puerto Ricans.

The public has a right to know the facts about natural disasters and their aftermath, and neither the Rosselló nor the Trump administrations have been honest with us about this. There is no way to overstate the severe public health crisis still unfolding in Puerto Rico nearly ten months after María. As we have seen in the失败在tempts at restoring the electrical gridin anticipation of the next hurricane season (just a few days away from starting!), neither social nor economic justice has been prioritized. What is being prioritized by the Puerto Rican government are juicy contracts forunqualified (but well-connected to the Trump administration) contractorsand government agency executives tasked with dismantlingpublic schools,社会保障体系,andlaborprotections. What is being prioritized is violent police repression to silence civil resistance to austerity measures bytear gassing childrenand other non-violent demonstrators.

Latinas lead the way towards a recovery in Puerto Rico

But there is hope. Leading the way towards an equitable recovery for Puerto Rico are multiple grassroots and national advocacy organizations—and Latinas are leading the way here. Recently I had a chance to see their work in action at a recent summit ofLatina and Latino environmental professionals. Thecompañerasat theFundación Fondo Acceso a la Justiciaare providing legal assistance to appeal denied FEMA aid requests—a complicated and very cumbersome process.Local Sierra Club activists in Puerto Ricoare providing solar panels and helping to increase the skills of local community leaders that can create strong and resilient neighborhoods for when the next hurricane hits.Latinas with Oxfam Americahave helped convene grassroots in Puerto Rico with FEMA officials so that the federal agency can have a better understanding of the language and cultural barriers that prevent people from accessing aid. Latina scientists fromCienciaPRand other scientific organizations areconvening a workshop in the fall in Puerto Ricoto educate Puerto Rican and Puerto Rico-focused scientists on how to engage in the pressing science-policy debates and decisionmaking that are vital to safeguard our health, environment, and democracy.

我们需要一个解决气候变化问题的工具nd knowledge produced by science. We need to do so with special attention to the most vulnerable populations, be they in the Caribbean, the Gulf Coast, or in inland cities or rural areas. If we do not, we will see more of these deadly impacts as climate change continues to fuel more intense and destructive hurricane seasons.

About the author

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Dr. Declet-Barreto earned a Ph.D. in environmental social sciences, M.A. and B.S. degrees in geography, and an associate’s degree in geographic information systems, from Arizona State University. At UCS, his research maps, analyzes, and finds solutions to the unequal human health and livelihood impacts of environmental hazards, particularly those exacerbated by climate change.