Building Resilience in Puerto Rico

On September 20, 2017, Hurricane Maria struck the island of Puerto Rico. With winds of up to 155 mph, heavy rain, flooding, and mudslides, the category-4 storm was the strongest to make landfall on the island since 1928. Puerto Rico’s infrastructure was devastated; roads, bridges, buildings, and homes were destroyed. The Puerto Rican government estimated that repairing infrastructure and services would cost $132 billion.

The human costs were also startling. About 3,000 of the island’s more than 3 million inhabitants died, making Maria one of the deadliest hurricanes in U.S. history. Those that survived faced many challenges. Thousands were left without power for months or access to safe water, food, and shelter. Further, many suffered financially, as the agricultural and tourism industries, which employ a large proportion of Puerto Ricans, were hard-hit.

Helping Puerto Rico Recover

The expansive impact of Hurricane Maria on Puerto Rico sparked action among a group of Hopkins affiliates, all Puerto Ricans who now live in the continental U.S. This interdisciplinary group—composed of two physicians, a PhD student in health communication, and an electrical engineer—founded Puerto Rico Stands to help the island recover.

Puerto Rico Stands focused their efforts on Sector Maná, a rural area in the mountainous municipality of Barranquitas. Sector Maná had been directly hit by the hurricane, and many residents didn’t receive help for weeks. Although the community was devastated, Sector Maná had the advantage of strong community leadership, which the Puerto Rico Stands team recognized was essential to their ability to work with the community from afar.

Puerto Rico Stands worked closely with José Carlos Sánchez Cintrón, a leader with El Familión, a community organization in Sector Maná. “When I had the first conversations with Puerto Rico Stands over the Internet, it was a light in the dark,” says Sánchez Cintrón. “We had lots of families with no food, no power, no water services. Sharing this message with the community, that we were working with this group called Puerto Rico Stands outside of the island, gave people hope moving forward.”

Assessing the Community's Needs

Puerto Rico Stands started with providing emergency aid—and lots of it, totaling over 5,500 pounds of supplies—but they wanted to make a longer-lasting impact. Their goal was to enable community members to become more self-sufficient and resilient, so that they could recover from the hurricane as well as other challenges that might arise in the future.

In an interview for the American Health Podcast, Puerto Rico Stands co-founder Yonaira Rivera, the former PhD student who is now an assistant professor of communication at Rutgers School of Communication and Information, explains the group’s approach: “We really believe the best way to do this is by providing communities with the resources, skills, and tools they need to enact change themselves ... You are empowering [them] by building from within, and meeting a community where they are, not where you want them to be.”

The first step was helping the community identify what it needed. In January 2019, with funding from the Initiative, Puerto Rico Stands completed a community needs assessment of 200 families in Sector Maná, to identify needs, resources, and priorities. “From there, the Puerto Rico Stands team brainstormed a plan of attack, to ensure that we had a framework that those needs were addressed—and at the same time, we gave them a framework to organize and work from. We made it a point to build our efforts around those needs and interconnect them to help them better organize and tackle those challenges,” said Rivera.

“When I think about Puerto Rico Stands and what their organization means within the community, the most significant thing that comes to mind is how they helped us structure our efforts,” said Sánchez Cintrón. “Their needs assessment taught us the importance of truly understanding the needs within the community-to deeply understand them to better serve them.”

One of the themes that arose was the need for mental health support; community leaders were burned out and exhausted. In response, Puerto Rico Stands organized a community event called Alegría para Maná (Happiness for Maná) on the eve of Three Kings Day, a major holiday in Puerto Rico. The celebration included free food, music, and gifts for children; a motivational speaker; and mental health workshops focused on managing emotions and burnout as well as increasing resiliency. Those workshops were conducted by Crear con Salud, a mental health nonprofit organization that is also part of the Puerto Rican diaspora in the U.S.

Using findings from the community needs assessment, Puerto Rico Stands then hosted a capacity-building workshop to prioritize projects and efforts. Small breakout groups were formed to discuss the most pressing community needs identified in the community needs assessment, and to develop a community project plan to determine courses of action to meet those needs. This plan continues to be used as a reference point for current and future community-led projects.

Forming a Long-term Partnership

Three years later, the impacts of the hurricane are still being felt in Sector Maná—as are the effects of a series of earthquakes in 2019 and 2020, as well as the coronavirus. Galvanized by their work with Puerto Rico Stands, Sector Maná’s leaders created Ruta Solidaria, a digital mapping platform that identifies areas of need and enables targeted responses. “When Puerto Rico Stands adopted us, we saw the effect of it in how the community was able to get back on its feet. When the earthquake struck, we thought, “What would Puerto Rico Stands do with this?” and then we took that example to stand up a platform that would allow people who wanted to offer help to be able to take it to the people in need," said Sánchez Cintrón.

In response to the coronavirus pandemic, Sector Maná’s leadership iterated on the Ruta Solidaria model to form Llamada Solidara, a kind of phone tree that supports families dealing with loneliness and other general health concerns related to the pandemic.

The collaboration established by Puerto Rico Stands and Sector Maná will continue. “The work is far from done,” said Rivera. “We have the earthquakes, we have COVID, and whatever else comes next. … We really need to continue to help communities in meeting needs that emerge from these kinds of emergencies. They also highlight the need of developing community strategic plans that allow for proactive work rather than reactive work. We really do look forward to using our skills and lessons learned moving forward as Puerto Rico Stands, and helping community leaders like Jose Carlos translate this into other efforts across the island.”

Puerto Rico Stands was founded by Yonaira Rivera, Hadi Esieley-Barrera, Sara Muñoz Blanco, and Margarita Ramos. Johns Hopkins faculty advisors on the community needs assessment were Kathleen Page, Daniel Barnett, and Janice Bowie.

To hear more about Puerto Rico Stands, download the July 2020 episode of the American Health Podcast.