As Puerto Rico braces for hurricane season, new estimates suggest the death toll from Hurricane Maria was almost 70 times higher than previously recorded.
Researchers from Harvard T.H. Chan School of Public Health and other institutions went door to door to interview over 3,000 households, and the results were alarming. According to the survey, Hurricane Maria left a death toll of over 4,000 people in its wake. The Puerto Rican government’s official death toll remains at 64. Puerto Rico’s Center for Investigative Journalism, CNN, Buzzfeed, and The New York Times have all reported higher statistics, combatting the government’s low assessment.
The survey numbers aren’t certain. The study, published in the New England Journal of Medicine, noted that an accurate death toll could fall between 800 and 8,000 because the researchers surveyed a small sample size compared to Puerto Rico’s overall population – 3.4 million U.S. citizens. Researchers in the area faced the same challenges that residents and aid workers have dealt with daily, constant flooding, landslides, lack of electricity and phone service, and lack of running water. They were forced to travel between neighborhoods using downloaded digital map data, and traverse difficult areas with off-road vehicles. “On average, households went 84 days without electricity, 68 days without water, and 41 days without cellular telephone coverage after the hurricane and until December 31, 2017,” according to the survey.
Surveyors concluded that inability to access medications and medical services played the largest role in raising the post-hurricane death toll, with 14 percent of households reporting they were unable to receive medication after the storm, and 8 percent reporting that they could not receive help from a medical facility because it was closed. When comparing their death toll with the recorded deaths during the same period in 2016, they found a 62 percent increase in mortality rate. The study notes, “death certificates are the primary source of mortality statistics, and in most jurisdictions, death can be attributed to disasters only by medical examiners.” Surveys like the one conducted through Harvard allow participant-reported data to demonstrate a broader image of the post-hurricane damage.
The randomization and small sample size kept the survey somewhat affordable and researchers were able to gather adequate data for $50,000, according to the The New York Times. They did not have help from the Puerto Rican government, but Carlos Mercader from Puerto Rico’s Federal Affairs Administration released a statement that the government welcomed the efforts and aimed to analyze them further.
The Puerto Rican government commissioned a similar survey by the Milken Institute School of Public Health at the George Washington University, and the Institute plans to release findings sometime this summer. Those findings will encompass a wider range of data including an in-depth review of death certification methods, but the initial review will cost around $305,000, according to The New York Times.
These studies may help disaster response time in the future and better prepare medical personnel in high-risk areas. People living in Puerto Rico are still suffering from power outages over seven months after the storm hit the country. Damage has made areas of the Caribean island unlivable and caused population displacement. “As the United States prepares for its next hurricane season, it will be critical to review how disaster-related deaths will be counted, in order to mobilize an appropriate response operation and account for the fate of those affected,” Harvard researchers concluded.
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