In Puerto Rico, as in much of the world, COVID-19 is compounding the risks facing vulnerable groups. Doctors Without Borders/Médecins Sans Frontières (MSF) teams here worked with community-based organizations and local health providers to offer medical aid to those who need help the most. Our services included home-based primary care as well as monitoring for COVID-positive patients. Over four months, we provided medical consultations to more than 1,200 patients, mostly older adults suffering from chronic conditions that can make them even more vulnerable to COVID-19.
At the end of September, MSF handed over medical activities to Puerto Rico Salud (PRS), a local organization formed by four members of our team seeking to carry on this vital work. Rolando Betancourt, who worked with MSF as a nurse and is a cofounder of the new organization, said he was personally moved to see how many people were struggling to survive without access to basic health services. “We set out to find a way to be able to continue the same work, with the same quality standards,” he said, “to reach the people who need it for a long time to come.”
MSF mobile medical teams traveled to isolated and marginalized communities, such as Buen Consejo in Rio Piedras, Puerto Rico. “There is a large aging population who are practically alone,” says MSF nurse Rolando Betancourt. “Many houses do not have potable water, nor do they have basic sanitation services.”
MSF physician Dr. Jonathan Caldera visits the home of a patient in Rio Piedras for a medical consultation. “Prior to the pandemic, the health care system had many problems. Those who were already in need in our community, when the pandemic came, it became much more difficult for them,” says Dr. Caldera.
MSF worked with local organizations and community leaders to identify people most in need of care, such as elderly people with chronic conditions that make them even more vulnerable to COVID-19.
Dr. Africa Stewart (left), an ob-gyn and MSF-USA board president, visits with the team in September to learn more about their medical activities. “The way that we're reaching patients here in Puerto Rico is by reaching out to community leaders…. All we had to do was ask.”
The MSF mobile medical team evaluates a patient during an in-home consultation in Humacao. “We have patients who have [chronic] medical needs, who live alone, who are bedridden,” says Dr. Jonathan Caldera (left). “We are here to provide this medical care, arriving in their homes in a safe way to address the gaps.”
MSF nurse Omar Martinez shows a patient how to thoroughly wash their hands during a home visit in Rio Pedras.
MSF nurse Rolando Betancourt (left) and MSF physician Dr. Jonathan Caldera (right) provide a medical consultation outdoors to a patient in Arecibo, where MSF partnered with a local organization, Ángeles Anónimos, to provide mobile medical services to marginalized communities.
People who are homeless often sustain wounds as a result of living outdoors exposed to the elements. A lack of access to basic supplies like water and soap puts them at increased risk of contracting COVID-19.
The artists of Colectivo Moriviví created this street mural in San Juan, commissioned by MSF. “It was important to us ... to also approach the subject of empathy,” says artist Sharon Gonzalez. The murals included uplifting messages like, "Let's cancel plans, not humanity" and “Distancing is physical, not social.”