by Garrett Burnham
At our conference in Vieques, the convened community members, organization leaders, and students received a presentation from Hēctor García of the US Department of Health and Human Services on potential plans to develop an alternative healthcare communication network across Puerto Rico that would greatly increase the coordination and effectiveness of the overall system. The basic premise of the proposal was the development of a hub and spoke network of hospitals and health centers to distribute information, materials and deliver patients to the best possible care in a more efficient manner. The planning and creation of this network would be based on set criteria to determine the ability of an existing facility to operate as either a hub or spoke. Some facilities would be omitted if they did not meet the following criteria: sufficient potential utilities, effective communications systems, actual and potential bed space requirements, storage capacity, geographic vulnerability, traffic and transportation access (land, air, and sea), workforce capacity and capability, and potential locations for Federal Medical Stations (FMS’s) with Disaster Medical Assistance Teams (DMAT’s) if needed.
The intent of these criteria is to ensure that all members of the network are operational after a disaster, prepared for an influx of patients, able to sustain aid, and are properly able to communicate with one another to avoid confusion and provide quick responses.
The proposal specifically cited the hospital in Fajardo on the main island as the hub for the network that would cover Vieques. A point which did not go unnoticed by the local community members in attendance who took the opportunity to voice concerns and criticism over the potential plans presented. One of the potential problems vocalized by the community present was the issue of communications. Vieques’s own emergency services have been struggling to initialize a communications tower in the center of the island for the past 15 years due to state-level red tape. The idea of communicating with a network of hospitals on the mainland seemed far fetched to most given the current state of funding and attention for better equipment. Many also worried that the proposal might even slow down and convolute communications that are already arduous. Many members were afraid that the presentation was more of the same empty promises they had received prior to and after Maria from federal and state agencies. In response to these concerns and others, Hector invited community members to become involved with the planning process, but whether this invitation fell on deaf ears remains to be seen. The Viequense have suffered a long history of neglect from public planning officials who often leave them out of such coordination and planning efforts.
On a final note, Hector touched on the need for rehearsing and planning out these networked systems prior to an actual disaster. Currently, the plan is to have drills with 68 hospitals currently participating in the process across Puerto Rico. It was incredibly valuable for us to see the engagement between government agency officials working to create solutions, and the people addressed in those solutions. In a very real way, these conversations are a petri dish for the functionality of budding solutions, and the public response to them in the early stages can unveil a lot of useful feedback. This is something we can all keep in mind as we work on our own research questions moving forward.