Nothing could prepare our clinician partners for the level of destruction we have seen in North America in recent weeks. In Puerto Rico, after Hurricane Maria ripped through the island following on the heels of Hurricane Irma, health centers and staff have struggled to provide services because of the lack of regular electricity, steady communication, and even sources of potable water. Reports that many of the relief efforts are bypassing the rural outposts are troubling. Our hearts and minds are with our colleagues and their patients in Puerto Rico as they struggle through these first weeks of what could potentially be the start of a major humanitarian crisis.

Increasingly in recent years, Migrant Clinicians Network has engaged with hundreds of clinicians at Federally Qualified Health Centers across rural Puerto Rico, working almost daily with many clinicians on the island who have shown an unyielding and exceptional commitment to improve care on the island. We have trained and provided technical assistance to primary care clinicians, promotores, and health center staff, on numerous topics and with in-depth programs. MCN has fostered centers of excellence with five health centers across the island to help them address pesticide exposure and work-related health as well as farmworker identification and screening. We’ve partnered to help centers and clinicians to foster outreach, recognition, and treatment of Zika virus.

Our Puerto Rican partners strive to improve care for their rural communities with noteworthy dedication; our most recent training in Puerto Rico occurred in the week between Irma and Maria. Despite the ongoing weather concerns, Puerto Rico clinicians stepped up to continue their efforts to improve care while preparing for a major storm.

The crisis in Puerto Rico comes in tandem with other natural disasters where our clinicians and their communities are deeply impacted. We are in shock with the devastation we have witnessed in the last month. Many of the most vulnerable communities have seen limited recovery efforts -- across central Mexico and in southern Mexico where earthquakes have reduced neighborhoods to rubble, in the poorest farmworker regions of the Gulf Coast and the Southeast like in southern Florida which have limited funds to rebuild, in communities across the West ravaged by wildfires. Each of these regions has experienced extensive damage and heartbreaking loss.

When disaster strikes, the vulnerabilities of underserved populations are exposed and the rift of access to care grows. We commend the many clinicians in our network who are working hard to improve conditions for the underserved to help build resilient communities in the face of such crises, and we stand with our clinician partners through these troubling hours.

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