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Disaster Impact and Health System Resilience: A Case Study of Hurricane Maria in Puerto Rico
Pallab Mozumder1, Linnette Rodriguez-Figueroa2, Mayra Quiles-Miranda3
1Department of Earth and Environment, Department of Economics, and Institute of Environment, https://ror.org/02gz6gg07Florida International University, USA.
Puerto Rico's health system faced major challenges after Hurricane Maria due to resource, management, and policy failures. Improving health system resilience requires decentralized power, insurance reform, better coordination, and equitable federal funding.
Area of Science:
- Public Health
- Health Systems Research
- Disaster Medicine
Background:
- Hurricane Maria exposed significant vulnerabilities in Puerto Rico's health system.
- Systemic challenges in resource, management, and policy domains impacted health system resilience.
Purpose of the Study:
- To examine systemic challenges to health system resilience in Puerto Rico post-Hurricane Maria.
- Focus on resource, management, and policy domains affecting healthcare delivery.
Main Methods:
- Semi-structured interviews (n=62) with diverse stakeholders.
- Thematic analysis of transcribed and translated interview data.
Main Results:
- Prolonged power outages (mean 62.7 days) caused cascading failures in water, transport, and communication.
- Management issues included depleted resources, staff burnout, and migration, leading to long wait times (6-8 months).
- Policy constraints like insurance pre-authorizations and capped Medicaid funds exacerbated vulnerabilities, particularly in rural areas.
Conclusions:
- Interdependent failures in infrastructure, management, and policy undermined health system resilience.
- Building future resilience necessitates investment in decentralized power, insurance protocol reforms, improved inter-agency coordination, and equitable federal financing.
- Addressing these issues is crucial for preparedness against climate-related disasters.
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