SAN JUAN – As part of its COVID-19 response in the United States Doctors Without Borders / Médecins Sans Frontières (MSF ), has been providing support to health facilities, conducting health promotion activities for high-risk communities, and bringing home-based medical care to vulnerable people across Puerto Rico, the medical humanitarian organization announced.
“Puerto Rico is facing a COVID-19 outbreak as it continues to grapple with the health impacts of two devastating hurricanes in 2017 and a sequence of powerful earthquakes earlier this year. When the first cases of COVID-19 were reported in March, the island’s health care infrastructure was already under extreme strain, ”the organization said in a press release.
“The health care system and all facilities have had to make major adjustments to operations, including deferring and delaying non-COVID-19 care,” said Sophie Delaunay, MSF project coordinator in Puerto Rico. "Telemedicine was not accessible to many people and high unemployment contributed to worsening health conditions. We realized people already in a fragile state of health were being neglected. ”
Since April, when MSF teams first arrived, the organization has been helping to support the immediate needs of health facilities and communities in Puerto Rico as COVID-19 cases increased. MSF has distributed personal protective equipment (PPE) and conducted infection prevention and control (IPC) trainings for essential workers. It has brought health promotion activities and hygiene kits to communities at higher risk for COVID-19 transmission, “to give them the information they need to protect themselves and help limit the spread of the virus,” the release reads.
In mid-June, MSF formed a mobile medical team to travel to remote areas and provide home-based primary care and carry out consultations at pop-up clinics to serve vulnerable people across the island. MSF has visited communities in Caguas, Loiza, and Utuado so far.
When the “stay-at-home” orders to slow the spread of COVID-19 were put in place, “these restricted movements meant that it was even more difficult for vulnerable people, as well as those living in isolated areas, to seek health care or follow-up care for their chronic or acute medical conditions, ”the organization explained.
“ Before COVID-19, Puerto Ricans were already struggling to cope with day-to-day life, after the string of natural disasters, ”said Jonathan Caldera, an MSF physician working in Puerto Rico. “Some people, such as the elderly and those with chronic conditions, find themselves in continuous need of medical assistance. COVID-19 has just exacerbated their needs and has further stressed the health system, just as we enter hurricane season. ”
MSF identified 21 health facilities that needed PPE materials and some requested infection prevention and control training. Over two months, MSF distributed more than 20,000 PPE kits, 4,000 masks, and 14,500 face shields and conducted 60 hours of training for more than 100 participants, with 50 percent participation in “Training the Trainers” workshops.
“We were told that some emergency rooms could only provide staff with one mask per week, ”said Delaunay. “In any response, it's critical that frontline workers have the equipment and information they need to stay safe, so we set out to bolster PPE supplies and to train these workers on how to mitigate risks in health care settings as much as possible.”  At the same time, MSF partnered with community groups who were assisting the homeless, the elderly, people with substance abuse disorders, and families who have been affected by the recent earthquakes to distribute 3,700 hygiene kits.
“In order to give people greater agency over their health and protect the health of others, MSF — with local partners — conducted health promotion campaigns that focused on hand washing, wearing face masks, and physical distancing,” the organization added.
MSF has programs in more than 70 countries . In the United States MSF has worked to provide testing and health promotion to migrant farmworkers in Florida provided support to the homeless and housing insecure in New York City , and worked in Native American communities in the Navajo Nation and Pueblos. In Michigan MSF focuses on supporting staff in nursing homes and long-term care facilities housing the elderly.