A new study estimating that more than 4,600 people died as a result of last fall’s devastating hurricane in Puerto Rico has reignited anxieties among educators still reeling from the storm’s damage to the island’s school system.
The study, published this week in the New England Journal of Medicine by researchers from the Harvard T.H. Chan School of Public Health and other institutions, offers an estimate far higher than previous tallies, including the official government count of 64. Other organizations also had challenged the official figure, including The New York Times, which placed the count at 1,052 based on a yearly comparison of mortality data.
Although the study does not break down deaths of school-age children, it estimates that citizens under the age of 55 accounted for 5.2 of every 1,000 deaths. Mortality rates for all age groups increased following Hurricane Maria.
The latest research comes as the island’s educators prepare for another hurricane season while still recovering from the previous storm, which temporarily shut the doors of about 1,200 schools serving 350,000 public school students.
According to an April statement from the Puerto Rico Department of Education, schools have lost nearly 39,000 students since May 2017. At the time of the statement, only half of existing schools were at 60 percent of their capacity.
In February, the Puerto Rico Department of Education began a formal needs-assessment of all students, starting in the 3rd grade, and teachers. It aimed to determine which schools need aid from counselors and social workers in managing trauma triggered by Hurricane Maria. Based on the assessment, a team of 30 mental-health professionals have been trained to assist in schools that are highly affected.
Still, the formal needs-assessment is not enough to counter the emotional toll of Hurricane Maria, according to Grichelle Toledo, the secretary general of the Asociación de Maestros de Puerto Rico, Puerto Rico’s teachers’ union.
“We need at least two or three [social workers] in each school to impact our communities,” Toledo said. “They’re trying—they’re going to schools—but they’re not able to do enough.”
Tallying the Losses
The Harvard study, which looked at deaths from Sept. 20 of last year, when the storm made landfall, through Dec. 31, surveyed 3,299 randomly chosen households. Researchers used digital tools to ensure that they gathered an accurate sample.
“What you can see quite clearly is after Hurricane Maria you can see more deaths in the younger age groups,” said Caroline Buckee, an associate professor of epidemiology at Harvard School of Public Health, who was involved in the study.
In the survey, the primary cause of death was the interruption of medical care. On average, households went 84 days without electricity, 68 days without water, and 41 days without cellphone coverage. As a result, about 14 percent of households said they could not access medications and 9 percent could not access respiratory equipment, in addition to others who reported issues with closed medical facilities and absent doctors.
“A lot of people died afterwards; it wasn’t just the hurricane,” said Alberto García Moll, a forensic scientist and professor at the Interamerican University of Puerto Rico. “When you count on a machine for your life, you’re dead immediately.”
The government death count is assumed to be low due to its reliance on death certificates. In Puerto Rico, every disaster-related death must be confirmed by the Institute of Forensic Sciences. This would require the body of a deceased person to either be brought to the capital, San Juan, or for a medical examiner to travel to examine the death, which wasn’t always possible under the post-hurricane conditions. Deaths because of poor conditions following the hurricane, but not directly tied to the storm, were not included in the official count.
In addition to the increased number of deaths, Puerto Rico suffered substantial population displacement in the wake of Hurricane Maria. The median age of those staying, or dying, in their households was 50, while the median age of those who left and did not return, or were missing, was 25. The study found that 41 percent of those displaced moved to parts of the mainland United States.
In April, the Puerto Rico education department announced that it would close 283 public schools this summer due to decreasing enrollment, opening new wounds for students and teachers. Many schools are unsure of how to gauge enrollment for the coming school year, with some considering online enrollment as an option.
“This year that will be delicate because they won’t be able to [predict enrollment] during the summer,” Toledo said. “It’ll be a mess. A mess. I would describe it as chaotic.”
Puerto Rico has also extended the current school year, officially closing classrooms on June 6.
But with hurricane season officially beginning June 1, many residents are worried.
“There’s not enough preparation. A lot of people are still out there with the blue tarps that FEMA gave them [after Hurricane Maria’s damage]. When are you going to get the money to rebuild your roofs? Why has it been so slow?” Moll said.
The Puerto Rican government has commissioned an external review of the death-registry data by the George Washington University, which has not yet been completed.
“The Government of Puerto Rico welcomes the newly released Harvard University survey and we look forward to analyzing it,” Carlos Marcader, executive director of the Puerto Rico Federal Affairs Administration, said in a statement. “As the world knows, the magnitude of this tragic disaster caused by Hurricane Maria resulted in many fatalities. We have always expected the number to be higher than what was previously reported.”