Introduction Hurricane Maria was the strongest hurricane to strike Puerto Rico in nearly a hundred years when it made landfall on the tiny island state in September of 2017 (Amnesty International, 2018). Maria followed upon the heels of Hurricane Irma, which had struck the island only a mere matter of weeks before. Nearly 3000 died as a result, according to Puerto Rico’s Governor and tens of thousands of people were displaced and forced to take up temporary shelter that gradually took on a character of permanence as the island struggled to cope with the devastation of the Category 4 hurricane (Amnesty International, 2018). Losses were estimated at some $90 billion. The fact that Puerto Rico was still reeling from the damages caused by Irma, which hit on September 6th, meant that local organizations were ill-prepared to cope with a second larger hurricane on September 20th. Irma had already “caused the collapse of the electric power system and significant infrastructure damage in the northeast region of Puerto Rico”—and power had not yet been fully restored when Maria landed (de Arzola, 2018, p. 477). While Irma had spared the southwestern part of the Island, Maria left not stretch of land unscathed: the devastation was total. 150 mph winds slammed into the island and tore across it completely. Radar, weather stations, cell phone towers, and electrical power were all wiped out (de Arzola, 2018). Only a single radio tower remained, but in order to use it individuals had to wend their way to the tower itself. Drinking water was in scarce supply, roads were obstructed by debris, flooding made other areas inaccessible, and hospitals were overwhelmed (de Arzola, 2018). It was in this environment that Puerto Rico’s Emergency Management had to act. This paper will discuss the preparation, planning and execution of Puerto Rico’s response and show where the island failed and where it succeeded.

Preparedness

The Puerto Rico Emergency Management Agency only had in place a very general emergency response plan in the case of hurricanes. The general response plan essentially served as a guide for various organizations and agencies in terms of what they needed to do in the event of a hurricane. It did not list specific steps or detailed instructions on action items or how responses should proceed, in what order, who should lead, how the overall response should be organized, and so on. It was a plan that essentially was not a plan (Florido, 2018).

Hospitals in Puerto Rico, for example, were used to responding to hurricanes—just not to ones the size and force of Maria. Though they struggled in terms of resources, hospital personnel were all trained in what to do and how to proceed: Southwestern Regional Academic Medical Center (SW-RAMC), a nonprofit organization created in 2006 under Puerto Rico State Law had been training hospital staff, medical students and residents on emergency responsiveness. As de Arzola (2018) notes, “before Hurricane Maria, hospitals and their residency programs followed emergency preparedness protocols that included reducing the number of patients, ensuring adequacy of supplies, and formulating contingency plans for staff to cover hospital services during the storm” (p. 478). The hospitals were prepared with generators and personnel who understood what to do in the wake of the hurricane. Most of the residents were able to get to their facilities to work after the hurricane, though some of them had completely lost their homes. A leadership team was on hand to monitor the recovery, with meetings taking place every 6 hours until electricity was restored, and then meetings were held daily (de Arzola, 2018). Members of the Federal Emergency Management Agency, the National Guard, and nongovernmental organizations met with the health coalition that was established, which “enhanced communication among agencies, allowed prioritization of areas of need, and ensured that southwest Puerto Rico was adequately served by all agencies” (de Arzola, 2018, p. 479). This is one example of how Puerto Rico was prepared and followed the plan accordingly.

Another example is the Public Health Emergency Preparedness Cooperative Agreement (PHEP) Program that had been in place since 2001. This program was designed to place a Center for Disease Control and Prevention (CDC) agent on-site to help respond to emergencies and prevent the outbreak of infectious diseases. In response to Maria, this plan was implemented accordingly and followed: “The CDC field scientist, alongside local staff, inspected potential vaccination sites, assessed their power needs, and worked to make them operational....

As a result, more than 25 additional vaccination sites could provide services, saving countless lives” (CDC, 2019). Thanks to the planning of the CDC and local staff in Puerto Rico, the spread of disease in the wake of Maria was addressed in accordance with preparations made.
Internal and External Reactions

At the governmental level, the emergency planning and preparation was mainly inadequate and ill-formed. The internal reactions to the hurricane were unhelpful as political squabbling made for poor leadership and ineffective response. It was generally left up to individual agencies and organizations to prepare and act on their own plans, and so in individual spheres—such as in health care—there was some organization, but beyond that the response, internally, was hampered by disorganization at the upper levels of governance. For example, there was little coordination among local politicians, and even externally, with help coming from the U.S., there were many criticisms. FEMA for instance was criticized for its response to Maria, even though FEMA had been there ahead of time helping to provide as much help as possible to an island already suffering from one hurricane two weeks earlier. FEMA argued in its defense that local politicians were ineffective at leading and cooperating because they were unwilling to collaborate with other parties and rivals (Achenbach & Hernandez, 2017). Another issue was that supplies from the U.S. could not be easily shipped from the U.S. to Puerto Rico to help address the resources issue because of a one hundred year old law known as the Jones Act. The Jones Act made it illegal for ships...…destroyed communications infrastructure, was not facilitated at all by the pettiness of local players.

The kind of communications that went out to the public were typically misinformed or deliberately misleading, with reports trying to inform the public that the devastation was not as bad as seemed and that work was underway to restore power when no such thing was true. The government released communications about power being restored in towns where power was still out, and the point of these misleading PR stunts was to help restore morale and give the people the false hope that things were improving quickly—but people instead quickly saw through this ruse as their situations did not improve after days, weeks and months of now power.

Cultural and Resource Issues

One of the main reasons for the failure of an adequate emergency plan and response to the Hurricane Maria was simply that the culture in Puerto Rico was not one in which planning and foresight was deemed as particularly essential. The island had never suffered such a one-two blow as what was delivered by Irma and then Maria two weeks later. Just dealing with Irma was a big enough problem, but Maria simply kicked the legs out from under the island and there was little the people could do. It was limited in terms of natural resources and its culture was really one in which the people were more inclined to simply accept their circumstances and roll with the punches, bad as they may be, than plan ahead, put aside political differences, and figure things out. Only those organizations like the ones in the health care community that were informed by a different culture showed any sense of preparedness.

As Samaan and Verneuil (2008) pointed out in their study of Katrina, the spirit of mission is really what is needed in order for an organization or agency to respond effectively to a disaster of this scope. That spirit is one that has to be developed and nurtured overtime, which is why the U.S. Coast Guard was so effective at delivering a solid response in New Orleans: it had created a solid culture and a solid spirit of mission among its personnel. This spirit is what was missing locally among the people in charge of running Puerto Rico.

Conclusion

When Hurricane Maria struck Puerto Rico in 2017 it essentially destroyed the island’s ability to function in any structural way. Homes, agriculture, power, roads, water—all of it was gone and there was really no plan in place that would help the people to start climbing back out of the very deep hole that Maria put them in. The island had to rely on the U.S. for much assistance, while the Puerto Rico government made many promises about being better prepared next time around. The problem is that unless the spirit of the government changes, the same lack of preparation will be an issue again and again and again.

References

Acevedo, N. (2018). Puerto Rico lacked disaster planning, communications…