Leovigildo Cotté died after not receiving the oxygen he needed at the only shelter that exists in the town of Lajas on the southern coast of Puerto Rico, which has been without electricity since Hurricane Maria careened through a week ago.
Not even his connections to the government could save him.
“The generator never arrived,” said Lajas Mayor Marcos Turín Irizarry, who said he looked for oxygen for Cotté — father of the former mayor of that same town — “turning every stone” but could not find it.
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Cotté is one of the unaccounted victims of Maria, the potent hurricane that devastated all of Puerto Rico with sustained winds and gusts of up to 200 miles per hour. On Wednesday, the Puerto Rico government, maintained that the official number of deaths as a result of the catastrophe was 16. But the Center for Investigative Journalism (CPI, for its initials in Spanish) has confirmed that there are dozens of hurricane-related deaths and the number could rise to the hundreds.
The storm-related fatalities are mounting with each passing day, and official numbers are not counting patients who are not receiving dialysis, oxygen and other essential services.
Among those at risk are people such as Pedro Fontánez, 79, who is bedridden at the Pavía Hospital in Santurce in San Juan and was due to be released even though he lacks electricity at home to support the oxygen and gastric tube-feeding he needs to keep him alive. His daughter, Nilka Fontánez, went to the government’s Emergency Operations Center desperately seeking help, but was told they were not accepting patients.
“There’s no information,” said a frustrated Fontánez.
The dead are at the hospital morgues, which are at capacity and in remote places where the government has yet to go. In many cases, families are unaware of the deaths. The government’s Demographic Registry is responsible for certifying deaths so bodies can be removed by funeral homes, many of which are not operating because of lack of resources. The agency began to certify some of the dead Monday, Health Secretary Rafael Rodríguez-Mercado confirmed in an interview.
Public Safety Secretary Héctor Pesquera told the CPI that the names of the dead because of the hurricane will not be revealed until relatives can be notified. The continuing lack of communication has kept many people from knowing the whereabouts of their families. Since the storm’s immediate aftermath, many people have gone daily to radio stations so the on-air personalities can announce the names of family members with whom they have been unable to communicate.
A week after Maria, the government of Puerto Rico is struggling to supply basic services, such as fuel, road access and electricity. It provides a progress report of the efforts through a daily press conference at the Emergency Operations Center in San Juan. But not discussed is that the number of deaths resulting from the disaster are much higher than the 16 or 19 that have been given as the official tally.
CPI sources in half a dozen hospitals said those bodies are piling up at the morgues of the 69 hospitals in Puerto Rico, of which 70 percent are not operating. The majority of the hospital morgues that provided information — including Doctor’s Center in Bayamón and Santurce, Pavía Hospital in Santurce, Manatí Medical Center, Dr. Pila in Ponce, Río Piedras Medical Center, Mayagüez Medical Center and the HIMA hospitals in Caguas and Bayamón — are at full capacity. Those hospitals are among the 18 that are partially operational.
CPI also has learned that the Institute of Forensic Sciences is also full of bodies and that 25 of those are hurricane victims. On Tuesday, the IFS reported that it had increased its storage capacity for bodies with a trailer that was obtained through The Morgue federal program.
It’s unclear what is happening with the deceased who are at the morgues of the 51 hospitals that have had to close their doors.
Secretary Rodríguez-Mercado acknowledged that hospital morgues are full. He said the accumulated bodies cannot be removed from the morgues by funeral homes until the deaths can be certified by the Demographic Registry, which barely began operating from regional emergency centers Monday.
Rodríguez-Mercado said that he documented seven additional hurricane-related deaths at three hospitals on the island’s western region he was able to visit on Monday, even as the official death toll remains at at least 16.
Rodríguez-Mercado did not know the status of the situation at the hospitals in Ponce on the southern coast because the region remains completely cut off from communications. But he planned to go to there to explore the matter.
“We’re finding dead people, people who have been buried, [people] have made common graves,” Rodríguez-Mercado told CPI. “We’ve been told people have buried their family members because they’re in places that have yet to be reached.”
The scenario is grim.
Hospitals that had to close their doors after the storm have more than 4,000 beds. Asked what happened to those patients, where they were transferred, the health secretary responded with a sincere, “I don’t know.”
Another looming problem is that patients are arriving in critical condition, with ventilators, for example, and with poorly documented records of medical procedures at the hospitals where patients were originally admitted. For that reason, and because of the limited resources and fuel to power generators, the majority of hospitals that are currently “operational” are not accepting transfers or new patients, sources said. The Río Piedras Medical Center in the capital, the government’s main hospital for this disaster, has been operating at half capacity.
Rodríguez-Mercado said officials would meet with authorities from the U.S. Department of Health to discuss the protocols used to handle cadavers to prevent a budding public health problem.
Meanwhile, the dead continue to accumulate.
“We’re fighting. I would love for the government to understand that it has to open dialysis centers. If they don’t receive the service, the patients’ health is compromised quickly and they die. And yes, they have died,” said Armando Rodríguez, vice president of the Grupo HIMA medical provider. He confirmed that the morgues of his two hospitals in Bayamón and Caguas are above capacity.
Meanwhile, thousands of doctors and nurses are at home unable to work, said Dr. Joaquín Vargas, president of the Puerto Rico Primary Physicians Groups Association, who was at the COE to see if the government would set up an operations center where they could at least answer calls from citizens.
The CPI also has learned that a large portion of specialized physicians is unable to work because hospitals don’t have supplies and the ability to conduct their procedures, nor basic resources such as fuel or electricity to run their medical practices.
The Center for Investigative Journalism (CPI), located at the School of Law at Interamerican University of Puerto Rico, is an independent, nonprofit organization that promotes and defends the citizens’ right of access to information through journalistic research, education and the promotion of transparency of public and private authorities.