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A lot of things can only happen with electricity, including providing adequate medical care. Most of Puerto Rico is still without power, and people expect further delays in bringing the electrical grid back online. The effort has been complicated since Puerto Rico canceled a controversial deal with a Montana company called Whitefish Energy. NPR's Jason Beaubien is in San Juan and brings us this story of the medical impact of the ongoing blackout.
JASON BEAUBIEN, BYLINE: One of Puerto Rico's top radiologists, Dr. Fernando Zalduondo Dubner, is battling with a diesel generator.
FERNANDO ZALDUONDO DUBNER: We're having trouble with it right now as we speak.
BEAUBIEN: Dr. Zalduondo is the medical director at the private San Patricio Medflix clinic in San Juan. With Puerto Rico's electric grid down, this generator that he's standing next to has been the sole source of power for his four-story medical complex.
ZALDUONDO: The other day, we had to cancel 70 patients that were here. Seventy patients...
ZALDUONDO: Seven-zero just because we rely a hundred percent on the diesel plant.
BEAUBIEN: For Dr. Zalduondo, the diesel isn't just a question of keeping the lights on in his office. MRI machines use liquid helium to cool superconductive magnets. If the MRI loses power for very long, the helium warms up, evaporates and causes serious damage to the imaging machine. That happened to 1 of his 2 MRIs.
Early Saturday morning engineers from Siemens, which makes the MRIs, are working to maintain his remaining MRI after the helium in that one dropped to a critical level. Forty days after Hurricane Maria, this section of San Juan is still without power. That's true for 70 percent of electric customers across the island.
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BEAUBIEN: Including, for instance, parts of Toa Baja just west of San Juan. Dr. Eduardo Ibarra is there making house calls for mostly elderly patients. He says the extended blackout is wrecking his patients' health.
EDUARDO IBARRA: I would say the ones I have visited, a hundred percent don't have electricity.
BEAUBIEN: There is of course no air conditioning, no fans, no refrigeration for medicine, of course no hot water, with temperatures rising well into the 80s.
IBARRA: Between no light and no water and no money and no help - so the patients started getting very sick.
BEAUBIEN: Bed sores are aggravated. Respiratory problems get worse. One of Carmen Garcia Lavoy's neighbors is using a handsaw as he works on rebuilding her house the old-fashioned way. All that was left behind of Garcia's house is a tiled cement slab. The 77-year-old Garcia talks to Dr. Ibarra about a host of medical issues. She can't see well. She had open-heart surgery last year. The examination takes place in the open air of what used to be her living room. Dr. Ibarra takes her blood pressure. She breaks down crying and says she hasn't been able to get to a doctor since the storm.
CARMEN GARCIA LAVOY: (Through interpreter) I've already canceled or lost two appointments with my cardiologist.
BEAUBIEN: Dr. Ibarra writes her a prescription for a hypertension medicine that she's run out of. A nurse traveling with him rubs her back. Garcia clutches the prescription as if it's a treasure. The official death toll from Hurricane Maria stands at 51. Dr. Ibarra is one of many people here who are saying that the true death toll from the storm is higher.
IBARRA: When you as a physician certify the death of a patient, you just put on the certificate cardiac arrest. You don't put something like Maria's related and so on.
BEAUBIEN: Nor does anyone list lack of roof or lack of diesel or lack of electricity as the cause of death. Jason Beaubien, NPR News, San Juan.
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