Updates from Vieques

Our 5th medical trip to Vieques (and 6th to Puerto Rico) since Hurricane Maria wrapped up a few days ago and was a resounding success. We were joined by a team from the University of Connecticut’s Department of Family Medicine and partnered with local community based organizations and organizers.

Photo Credit: Ambereen Sleemi

Health and Wellness for Vieques Youth

An important focus of this visit was to enhance health education and wellness for the adolescents on Vieques. Working at the local public middle and high school, 2nd year Family Medicine resident physicians gave presentations to over 60 students about hygiene, nutrition, substance-abuse, bullying and more. They did a great job! 

Photo Credit: Ambereen Sleemi

Prevention of chronic diseases is vital, especially here in #Vieques.  Rates of preventable illness are much higher than mainland Puerto Rico and the US.  People who live in Vieques are eight times more likely to die of cardiovascular disease and seven times more likely to die of diabetes than others in Puerto Rico. Vieques has a 30 percent higher rate of cancer than the rest of Puerto Rico, and nearly four times the rate of hypertension. In addition, the effects of Hurricane Maria had a profound affect on the mental health of inhabitants; thus there is a crucial need to confront this with a concerted effort.  Feedback from students and teachers was remarkably positive and we hope to build on this initiative to give students more knowledge about their health and well-being. A trip to the Vieques Boys and Girls Club made sure younger students also participated in focused health workshops. We also made our first visit to the Vieques Senior Center, bringing supplies, conducting well checks and speaking with seniors and administration about their specific needs. 

Home Visit Program 

Our teams continued our Home Visit Program, this time focusing on households in Esperanza.  Well-visits and home checks include assessment of home safety, roof/plumbing checks and food security.   

Photo Credit: Marc Baptiste

We were able to follow up with Claribel, who recently lost her husband after a long ailment. On our last visit, she was awaiting roof repairs and solar panels- happy to report she has both now thanks to local support. 

Photo Credit: Ambereen Sleemi

Photo Credit: Ambereen Sleemi

Photo Credit: Ambereen Sleemi

In addition, we identify the needs of caregivers who look after their homebound loved ones. Caregivers like the Solis family, which is dedicated to tending to their bedridden mother for years. They’re doing an amazing job, as were all the families caring for their loved ones here. Some need supplies, others need roof/floor repairs. Working with community organizations, we’re able to help connect needs to resources.  

Photo Credit: Marc Baptiste

NEEDS ASSESSMENT 

Continuing our partnership with local organizations/activists in Vieques, including Vieques Love, BiblioCeiba and Kathy Gannett, is vital to bring care to residents on this island. During our trip, we met with folks from Sociants--a digital platform designed to identify social determinants of health—to discuss a much-needed and overdue needs assessment on VIeques.  Participating in this initiative will allow for collection of important data that will inform our work to bring better medical care to Vieques. 

Thanks to our entire team who provided incredible preventive health education,  medical expertise and support for our work to bring the best care possible to Vieques. We thank Marc Baptiste, a remarkable photographer for lending his talent to document our work and the people for whom we care. To John and Amy Boggs and Laila O’Neal—we’re thankful you joined our team. To Drs. Guajardo, Rivera and Blumenfeld, thanks for bringing your U. Conn family to join ours. Go Huskies!

By: A. Sleemi, MD, MPH, Executive Director

Updates from Puerto Rico

In October, we returned to Vieques, Puerto Rico for our 4th visit this year to assist with post-hurricane medical care and recovery.  People on Vieques have had extremely limited access to healthcare since Hurricane Maria struck more than a year ago. The IMR team arrived on October 19th, and conducted a two day clinic in Esperanza, where we saw approximately thirty patients.  The team was made up of Drs. Sleemi and Schiller, two Emergency Medicine resident physicians from Maimonides Medical Center in Brooklyn, Drs. Suman Gupta and Cecily Sotomayor, and our colleague Ana Aurrecochea, a surgical nurse from California.

In addition to clinical care, IMR worked in conjunction with local community leaders  to provide home visits for Vieques’ more vulnerable patient population, in which we were able to assess needs and provide appropriate medications and follow up.  

The trip was short and sweet, but  there is still much to do. While Vieques has achieved a measure of stability in its access to healthcare, it’s still experiencing interference in basic infrastructure.  Electrical power is interrupted on a regular basis, putting patients reliant on ventilators at high risk for decompensation, as well as compromising refrigerated food and medications (such as insulin) for the more susceptible patient population.  Please continue your support of IMR so that we can support those who need it most.

Looking forward to a productive 2019!

IMR in Vieques

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Last week, we traveled to Vieques, Puerto Rico to help care for the population on the island that is still suffering from the aftermath of Hurricane Maria. We partnered with other organizations on the ground as well as Jordan Aid International to care for over 200 people on the island of Vieques. Vieques was particularly hard hit by Maria and has had a long-standing history of health disparities for the last few decades. The need for medical care on Vieques was glaringly obvious. Chronic conditions such as diabetes, high blood pressure, asthma and mental health issue such as depression and anxiety remain. 

Puerto Rican physician Manuel Betancourt triages patients

Since Maria, the public hospital had not opened to its full functioning capacity and currently there’s an urgent care center but all emergencies and obstetric care has to be obtained on the main island of Puerto Rico. This means that someone in need has to take a boat or plane to get to the main island for urgent medical care. IMR worked with a dedicated team of internal medicine, pediatrics, family medicine, gynecology, and many nurses and non-medical volunteers who made this three day clinic a tremendous success.

Thanks in part to the generosity of our donors we were able to provide medications, medical care, therapy, and disease management for the people of Vieques. We would like to especially thank MAP International for their medical supply donation. There’s a lot to learn about the history of Vieques, some of it can be found here.

IMR volunteer, Angela Baumeister, RPAC, listens intently to her young patient

As the need continues, IMR will continue to return to the island work with our partners to provide the best medical care we can. It’s unclear when the current medical crisis will be over, however we are committed to being able to help as long as we can. Our supporters donations and support can help us have a long-term presence in Vieques and Puerto Rico for as long as needed. Please consider making a tax-deductible donation below to help us continue our work. We are grateful for your support.

Thank you,

Ambereen Sleemi, MD, MPH

IMR team in Vieques

Update: IMR in Puerto Rico

Municipal water trucks delivering water to mountain towns in Lajas

Water is life everywhere

Homes destroyed, bits and pieces of a family’s home strewn down the mountainside in Morovis

Home visits, like this one to a 90- year old in Lajas, to the most elderly and infirm. Her severe arthritis in arms and legs makes walking impossible

Commonly seen sights along roads all over the island

The profound intimacy of home visits. Home bound seniors like Rosa, 97 years old, still have no running water

We have just returned from a week in Puerto Rice working with the Department of Health and the Puerto Rican College of Physicians and Surgeons. Each day, the DOH identified municipalities in need. This was done in cooperation with local mayors and community workers. Liz Santaniello, a family nurse practitioner joined me for the week long trip.

Our first day was spent in Canovanas and Loiza, one of the hardest hit areas on the island and the one with hundreds of people in refugee centers. We set up a clinic in town and saw dozen’s of people who needed care. None had electricity or running potable water. Over the week, we traveled to the south to Lajas, the mountains of Morovis, refugee's shelters in Salinas, and the hardest hit areas of San Juan, including Hill Brothers. Home visits to the elderly and frail, as support and reassurance that they will not be forgotten, were much needed.

Everywhere, we saw old and young alike in need of medicines, water and electricity. And everywhere we saw Puerto Ricans from all walks of life rise to this need and do the work that needed to be done to care for people. We were able to deliver 8 large bags of medicines, syringes, pain relievers, water purification tablets, bug spray and more to 100’s of people. 

Working with the local doctors and authorities ensured our efforts were directed to the most needy areas of the island.  IMR has committed to return to work with local Puerto Rican doctors to provide care, supply medical goods as well as technical support as long as the need exists.

- Ambereen Sleemi, MD, MPH

Surgical Director 

IMR begins assisting physicians in Puerto Rico

Approximately a month after Hurricane Maria devastated Puerto Rico, a team from IMR will travel to work with physicians and nurses at the Medical Center in San Juan. The Medical Center and Department of Health have been key local responders to the medical crisis in nearby towns.

Blue tarps over homes damaged by Hurricane Maria

Puerto Rican physicians we’ve spoken to report widespread illnesses such as infectious diseases like scabies and conjunctivitis, as well as untreated chronic disease like diabetes, asthma, and high blood pressure. All these left diseases left untreated can lead to severe complications. The fear of water-borne diseases exists and cases of Leptospirosis have been reported. Due to the continued lack of clean, potable water, there’s real concern of widespread infections.

We’ll spend a week working with the Medical Center teams. Thanks to the many who donated supplies and funding to help make this happen. Thanks to JetBlue and MAP International for in-kind donations.

This will be the first of many trips to help healthcare workers and the patients they care for. We’ll continue to return as long as we are able to help fulfill a need.