BURLINGTON, Vt. (WCAX) A Vermont doctor just returned from an aid mission to the island. She says she found frustrating bureaucracy and conditions that are putting more lives at risk.
"It's a real mess," Dr. Patti Fisher said.
Fisher says her two weeks in Puerto Rico were overwhelming. The scope of the tragedy there is hard to wrap your head around.
"It just feels like it's going to get worse," she said.
Fisher is used to tough situations; she's been on the front line of the UVM Medical Center's push to expand treatment for opiate addiction and has made several trips to Haiti, including providing emergency care after the earthquake seven years ago. So it wasn't the destruction and suffering in Puerto Rico that stunned her, but the uncoordinated and, in some cases, ineffective federal response. Three weeks in, most of the island does not have power or clean water.
"I think the death toll in this instance is going to rise as these systems aren't coming back online quickly," Fisher said.
Reporter Kristin Kelly: So basic health needs not being met...
Dr. Patti Fisher: Yes, right.
Kristin Kelly: Will lead to more deaths?
Dr. Patti Fisher: Right.
Kristin Kelly: It's part of the United States.
Dr. Patti Fisher: Yeah, it didn't feel like part of the United States.
Fisher was in Puerto Rico with the nonprofit Heart to Heart International, seeing patients in small town municipal buildings going house to house or going room to room in senior high-rises where elderly residents were basically stuck with no power; the elevators don't work.
"People were super appreciative of any little thing," Fisher said.
She calls conditions "third world-ish." So when President Trump visited during her trip and compared Puerto Rico's death toll to Hurricane Katrina's...
"Sixteen people versus in the thousands," the president said.
Fisher said it felt like salt in a wound.
"I just thought that's the most ridiculous statement ever," she said.
She says the disaster is still evolving. The death toll still rising and just getting basic help to people-- like medicine for chronic conditions like hypertension or diabetes-- is still close to impossible.
"The ministry of health isn't talking to FEMA," Fisher said.
One problem she ran into over in over was patients unable to fill prescriptions. Pharmacies are open. They have the meds. But many are charging cash even though the government says it will pay pharmacies back. Fisher told a FEMA worker on the ground who called into the command center in San Juan.
"He got me to a woman who walked over to the Ministry of Health person and she's like, 'Oh, no, that's not what's happening. That's not what they're supposed to be doing; they're supposed to be just filling medications.' I'm like, 'I understand that's what they're supposed to be doing but I don't think the pharmacies know that's what they're supposed to be doing and that's not what's happening in reality,'" Fisher said.
Bureaucratic hurdles even kept Fisher from actually practicing medicine for her first two days in Puerto Rico because she needed approval from the governor in San Juan. And because she knows the need is so great, Fisher is considering a return trip to help next month.