November is the last month of hurricane season and, although this year Puerto Rico did not have a direct impact from a hurricane, the air feels charged with memory. The names Katrina, Harvey, Irma, María, Michael, Dorian, Ian, and Helene echo in Puerto Ricans’ collective consciousness like familiar warnings. Those who experienced Hurricane María in 2017 still hold their breath when they see a storm developing nearby. This year, the worst of Hurricane Melissa missed Puerto Rico, but our Caribbean neighbors have not been spared. Puerto Ricans understand the shock and bewilderment of watching their lives, their homes, their livelihood, the infrastructure that helps people stay safe and healthy, all wash away in a matter of hours. Even after eight years of recovery and preparedness efforts, for some it’s hard to say that they are “ready” for the next one.
In those eight years, we have seen growth but also delayed recovery processes. The social vulnerability and affected infrastructure make any weather event a potential emergency. What was before just “seasonal rain,” now can become intense events that result in blackouts, communication interruptions, and the overall disruption of our daily lives. “We are not ready,” we recognize, and yet, our communities keep working. From community emergency planning to the resiliency of our food system, neighbors and community-based organizations have joined to rebuild with a sense of purpose. Since 2018, Migrant Clinicians Network (MCN) has been both a collaborator and a witness to how our communities repair and work with the main goal of creating self-owned and -managed systems. There is still much to do, and with unfinished roofs and mid-constructed roads, we still wonder if our houses can withstand the next one. We know the time will come, and we are not ready.
This writing does not come from hopelessness; on the contrary, it comes from the recognition that change is not always quick and that the energy for community efforts is not constant. It comes from acknowledging that the road is long, the work is hard, and the obstacles and challenges are many. It comes from knowing that year after year, organizations such as community health centers plant and cultivate community preparedness and response. It is from this recognition that, three years ago, several colleagues came together to design and propose a project aimed at supporting agricultural communities in their efforts to prepare, protect, and recover from climate-related disasters and emergencies.
Strengthening the Capacity of Community Health Centers to Address Extreme Weather Events in Agricultural Communities and Workers in the Caribbean is a project supported by MCN, Mentes Puertorriqueñas en Acción, and the US Department of Agriculture that seeks to strengthen what our communities have already begun with a community-focused curriculum for health center staff on emergency preparedness called Support Curriculum for Health Service Providers. Designed to support clinicians and their communities in Puerto Rico and the US Virgin Islands, this curriculum facilitates the navigation and use of resources and tools for all populations that have been developed by MCN or other organizations. This curriculum, composed of seven modules, covers topics such as sustainable agriculture, health and disasters, and advocacy and community leadership, and offers tools for diverse populations such as children, older adults, agricultural workers, and patients with chronic illnesses who live and experience natural disasters in their region.
This year, this curriculum was implemented by six health centers in the Caribbean, reaching more than 1,200 people. In collaboration with students from the University of Puerto Rico, we are presenting each of the curriculum modules along with best practices and lessons learned from their use and implementation in four health centers in Puerto Rico. In this edition of Streamline, we offer the first two articles of the series. More will be published in upcoming editions.
We invite you to follow this series and explore the Support Curriculum for Health Service Providers, available for download on the MCN website, in English and Spanish. Visit https://www.migrantclinician.org/resource/building-capacity-among-community-health-centers-address-weather-related-extreme-phenomena to learn more and access the materials.