Anonymous victims

Hurricane Maria’s death toll climbed long after rain stopped

Associated Press

SAN JUAN, Puerto Rico

Ramona Gonzalez did not drown when Hurricane Maria drenched Puerto Rico. She did not die in the tempest or from destruction wrought by the storm’s 154 mph winds.

Instead, this disabled, 59-year-old woman died a month later, from sepsis – caused, says her family, by an untreated bedsore.

In all, the storm and its aftermath took the lives of unfortunates like Gonzalez and thousands of others, many of whom could have been saved with standard medical treatment. This was a slow-motion, monthslong disaster that kept Puerto Ricans from getting the care they needed for treatable ailments, even as President Donald Trump lauded his administration’s response.

A year after Maria roared across the Caribbean, reporters for The Associated Press, the news site Quartz and Puerto Rico’s Center for Investigative Journalism have put together the most detailed portrait yet of the agonizing final days of victims of the storm, interviewing 204 families of the dead and reviewing accounts of 283 more to tell the stories of heretofore anonymous victims.

Trump cast doubt on the storm’s widely accepted death toll Thursday, tweeting that “3000 people did not die” when Maria hit after a near-miss by Hurricane Irma in September, 2017. He said the death count had been inflated “by the Democrats in order to make me look as bad as possible,” by adding unrelated deaths to the toll from causes such as old age.

But the joint investigation reflects how Puerto Rico’s most vulnerable fell victim to dire conditions created by the storms.

Disabled and elderly people were discharged from overwhelmed hospitals with bedsores that led to fatal infections. Medical oxygen ran out. People caught lung infections in sweltering private nursing homes and state facilities. Kidney patients got abbreviated treatments from dialysis centers that lacked generator fuel and fresh water, despite pleas for federal and local officials to treat them as a higher priority, according to patient advocates.

There was Ernesto Curiel, a diabetic who died of a heart attack after weeks of walking 10 flights twice a day to fetch insulin from his building’s only working refrigerator. Alejandro Gonzalez Vazquez, 47 – unable to obtain his anti-psychotic medication, he committed suicide instead of boarding his flight back to the U.S. mainland. Juana Castro Rivera, 52, dead of leptospirosis, a disease transmitted by contaminated water. After several visits to a community clinic, she was diagnosed – too late – by a hospital in a neighboring municipality.

Along with post-storm conditions, each death has a complex mix of causes that can include serious pre-existing conditions and individual decisions by patients, caregivers and doctors, making it difficult to definitively apportion blame in every case. But critics say many could have been saved by better preparation and emergency response.

“I was looking for help, and no one came,” said Maria Gonzalez Munoz, who spent 30 days after the storm caring for her sister in her blacked-out home.

The Gonzalez home is 3 miles from the convention center that served as headquarters for thousands of federal and local emergency responders for more than a month after the storm. Maria and her brother took Ramona to a hospital twice, and tried to get her aboard a Navy medical ship in San Juan harbor, but couldn’t save their ailing sister.

“No one was asking after us – no one from the government,” said Gonzalez Munoz, 66.

The hurricane’s true death toll has fueled debate since the first days of the storm, in large part because of the near-unique nature of the disaster.

The United States’ deadliest hurricanes have killed most of their victims with powerful winds and flooding in the hours and days immediately before and after landfall. The National Hurricane Center says that when Katrina struck Louisiana and other states in 2005, it caused 1,500 direct deaths and 300 indirect ones from causes such as heart attacks and failed medical equipment.

Largely due to decades of neglect and years of fiscal crisis, the Puerto Rican electrical grid collapsed into the United States’ longest blackout after Maria hit Sept. 20, 2017. That spawned a long and deadly tail for the storm, with hundreds of deaths coming long after the first weeks of the storm, as medical equipment failed and sick people weakened in the suffocating heat.

Researchers from George Washington University hired by Puerto Rico’s government estimated last month that 2,975 people had died because of Maria in the six months after landfall, a number Puerto Rico accepted as official.