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Avilés Mendoza GJ, Finne KP, Torre Leon F, Burke LM, Cabrera-Marquez J, Mercado Casillas AM, Malave G, Brown C, Kelman J, Kopp JB. Observations from the emergency management of dialysis patients evacuated from the US Virgin Islands to Puerto Rico following hurricane Irma. BMC Health Serv Res 2021; 21:1239. [PMID: 34784905 PMCID: PMC8593631 DOI: 10.1186/s12913-021-07194-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/19/2021] [Indexed: 11/21/2022] Open
Abstract
Two category 5 hurricanes, Irma and Maria, arrived in the Caribbean in September 2017 in rapid succession. On September 6, Irma devastated the islands of St. Thomas and St. John, in the Virgin Islands of the United States (USVI). Most medical infrastructure was damaged, including hemodialysis facilities, paralyzing dialysis operations. After Irma’s landfall, Puerto Rico served as a safehaven for thousands of displaced and repatriated persons from the impacted islands. These included a cohort of 129 hemodialysis patients evacuated from St. Thomas, USVI to San Juan, Puerto Rico from September 9−11, 2017. The hemodialysis patients arrived first at hotels in San Juan and were then transferred to a Special Needs Shelter, run by the Commonwealth of Puerto Rico and located in the Puerto Rico Convention Center. With the imminent arrival of Hurricane Maria, most patients were evacuated on September 19 to a special needs shelter on the campus of the Florida International University, in Miami, Florida. While in San Juan, hemodialysis treatments were provided by local nephrologists working with local hemodialysis centers. Here, we describe the challenges and the emergency management actions taken to ensure continuity of care, including providing dialysis, general medical care, shelter, food and transportation for USVI dialysis patients during their stay in San Juan, Puerto Rico. We describe here the experiences of federal and host state/territorial officials in the special needs shelter, in the context of the state/territorial and federal response to disasters, in order to provide ideas about challenges, solutions, and approaches to coordinating care for dialysis patients evacuated from a disaster.
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Affiliation(s)
| | - Kristen P Finne
- Department of Health and Human Services, 200 C Street SW, Washington, DC, 20515, USA.
| | - Francisco Torre Leon
- Atlantis Health Care Group, CARR, 199 Avenue Las Cumbres, #140, Guaynabo Medical Mall, Bldg STE 107, Guaynabo, PR, 00969, USA
| | - Lisandro Montalvo Burke
- Medical Advisory Board, Fresenius Kidney Care, FMC San Juan Dialysis Center, 461 Calle Francia STE, A-101, Antillas Warehouse, San Juan, PR, 00917, USA
| | - Jessica Cabrera-Marquez
- Office of Biosecurity, Puerto Rico Department of Health, 199 Ave Las Cumbres, #140, Guaynabo, Medical Mall Building Suite 107, Guaynabo, PR, 00969, USA
| | - Ana M Mercado Casillas
- Office of Biosecurity, Puerto Rico Department of Health, 199 Ave Las Cumbres, #140, Guaynabo, Medical Mall Building Suite 107, Guaynabo, PR, 00969, USA
| | - Grasiela Malave
- Office of Biosecurity, Puerto Rico Department of Health, 199 Ave Las Cumbres, #140, Guaynabo, Medical Mall Building Suite 107, Guaynabo, PR, 00969, USA
| | | | - Jeffrey Kelman
- Center for Medicare, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Jeffrey B Kopp
- Department of Health and Human Services, Kidney Diseases Branch, National Institute Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, MD, 20892-1268, USA.
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