Puerto Rico Department of Health Responds to Health Emergencies

The Puerto Rico Department of Health responded to health crises arising from Hurricanes Irma and María with the creation of a new Crisis Program Management Office.

State Labs Before Hurricane Maria - Puerto Rico - Unorganized

State Labs after Hurricane Maria - Puerto Rico - Organized

PRDOH State Labs Before and After Hurricane Maria: Hurricane Maria disrupted many essential services, including the testing and surveillance capacity of infectious diseases at the Puerto Rico Public Health Central and Regional Laboratories. The Central Laboratory in San Juan underwent minor repairs in 2019 to incorporate cutting-edge technology for pathogen diagnostics and testing. With the improvements and added capacity the Central Laboratory has taken a leap forward in their laboratory surveillance capabilities. Now, the lab is able to implement genomic surveillance for infectious diseases such as COVID-19.

Photos by Dr. Eddie O’Neil and Dr. Jennifer Concepcion Acevedo

December 7, 2021

After Hurricanes Irma and María devastated Puerto Rico in 2017, many government and nonprofit organizations sent funds to help Puerto Rico respond to health crises arising from the disaster. The Puerto Rico Department of Health (PRDOH) was tasked with balancing the budget and tracking expenses for more than $46,192,874 in aid that arrived to help the US territory—all while essential systems remained inoperable.

Managing such a large and diverse hurricane recovery package required a level of cross-coordination and tracking previously unseen at PRDOH. Puerto Rico’s Secretary of Health and his leadership team responded by establishing the Crisis Program Management Office (CPMO), dedicated to leading recovery coordination efforts. CPMO focused on managing and expediting business processes and worked closely with PRDOH program directors and leads to ensure grant funds were quickly allocated to address the areas of greatest need.

PRDOH, with support from CSTLTS’s Office of Island Affairs (OIA) and use of CDC’s hurricane emergency response funding, designed CPMO with a core coordinating group with responsibilities for accounting, quality management, administrative/business support, logistics and procurement, and grants management. Twenty-three projects were funded to provide staff, equipment, contracts for services, and supplies to help restore public health services island-wide.

As a result of CPMO’s oversight, PRDOH was able to ensure timely spend-down of funding and program execution to address critical public health needs following Hurricanes Irma and María, while ultimately improving the department’s capabilities to respond to future emergencies. Currently, PRDOH is on track to complete the following projects:

  • Install energy backup options to better prepare public health laboratories for future outages
  • Strengthen a vaccine cold chain system for the Vaccines for Children Program to ensure vaccines retain their potency and reduce vaccine waste
  • Institute an electronic property tracking system that automates, improves, and streamlines the inventory process of property (e.g., small and large equipment, including laptops and copiers)
  • Implement a vector control emergency response plan
  • Digitalize vital records (e.g., Electronic Death Registration System)

Although CPMO formed in response to an emergency, this new office will have far-reaching effects extending well beyond Puerto Rico’s 2017 hurricane recovery. The office successfully redefined and expanded PRDOH’s work with nongovernmental organizations—such as the Association of State and Territorial Health Officials, Association of Public Health Laboratories, the National Environmental Health Association, CDC Foundation, and the National Association of County and City Health Officials—increasing transparency and strengthening Puerto Rico’s ability to rebound from future emergencies. Building on the newly developed response capabilities and lessons learned following the 2017 hurricanes, CPMO was instrumental in supporting Puerto Rico’s subsequent responses to Tropical Storm Dorian in August 2019, earthquakes in January 2020, and the COVID-19 pandemic.

CPMO has helped PRDOH become better prepared to respond to crises before, during, and after disasters, including providing vital project management infrastructure and technical assistance to support Puerto Rico’s pandemic response.

For more information

Jessica Irizarry Ramos,  Puerto Rico Department of Health

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