Thursday, June 21, 2018
Doctors Perspective
The Rest of the story on Puerto Rico

By Dr. Anthony Policastro
Newscaster Paul Harvey was famous for his Rest of the Story presentations. A recent article in the New England Journal of Medicine shared that kind of news with us. When Hurricane Maria hit Puerto Rico last August, 64 reported deaths were related directly to the hurricane. That led to comments by President Trump that Hurricane Maria was no Hurricane Katrina which accounted for 1,833 deaths directly from the storm. Trumps statement was true at the time. Trump also tweeted that we cannot keep FEMA in Puerto Rico forever. That statement is actually less true. The study in the New England Journal of Medicine looked at the indirect deaths from Hurricane Maria and the final tally was 4,645 deaths. Most of those deaths were related to interruptions in medical care due to the storm. The medical care interruptions were due to a number of things. On average, households went 84 days without electricity, 68 days without water, and 41 days without cellular telephone coverage after the hurricane. In fact, by Dec. 31, 2017 (four months after the storm), 83 percent of households in remote areas were without electricity for the entire time period. The result was a number of medical issues. The most frequently reported problem was an inability to access medications. This was true for 14.4 percent of households. About 10 percent of households required electricity for respiratory equipment. In addition to households, this also impacted places like nursing homes who may not have back-up generators. We often do not realize how many people require this type of electrical support. Closed medical facilities were a problem. So was the fact that doctors could not get to those facilities. With telephones out, 911 services could not be accessed. Ambulances could not get to some areas even if there was a 911 call. Even hospitals with back-up generators could not get the needed gasoline to keep them running. We now rely more and more on medical care.

Much of that is medication or medical equipment related. Natural disasters frequently lead to these types of problems. It is true of every major hurricane. We saw it with Hurricanes Katrina, Sandy, Harvey and Irma. The difference in Puerto Rico is the immediate devastation was followed by geographical isolation. Aid could not easily reach the island. It is unfortunate that the rest of the story should be so sad. One would think our nation could do a better job of taking care of its citizens.

Weight loss seminars Nanticoke Weight Loss & General Surgery will host free weight loss seminars on Monday, July 9 at 5:30 p.m. and Saturday, July 28 at 10:30 a.m. at the Nanticoke Training Center, 121 S. Front St., Seaford. These seminars are designed to provide education to individuals considering weight loss surgery to help them make informed decisions on whether surgery is an appropriate option. The seminars will consist of educational presentations by Dr. Tarek Waked to inform individuals about the many benefits of weight loss surgery. Patients and their spouses, family members or friends are welcome to attend. Registration is required. To register for one of these free seminars, call 302-536-5395. To learn more about services provided by Nanticoke Weight Loss & General Surgery, visit

Diabetes support group Nanticoke Memorial Hospital hosts free diabetes support groups on Mondays four times a year from 5 to 6 p.m., in the Medical Staff Conference Room. Pre-registration is required. 2018 schedule- September 17 – “Move with Jonathan” with Jonathan Souder, MS, fitness director, Manor House December 3 – “The Dish on Diabetes” - Learn food preparation skills for simple, savory diabetic dishes. For more information or to register, contact Nanticoke’s Diabetes Education department at 629-6611, ext. 2288.