PONCE, Puerto Rico — Steven Rosario still remembers when Hurricane Maria struck the island on Sept. 20, and people at a shelter tied belts to buckling doors to keep them from being blasted open by 150 mph winds.
Then, “the belts broke and it took several of the guys to hold the doors back in,” he said; adding with a quip, “so we don’t fly like Dorothy in the ‘Wizard of Oz.’”
There was nothing funny about the view outside the shelter’s windows where uprooted trees sailed through the air. “We were really fearful that those trees might just go through those windows,” Rosario said.
A few weeks later, Ohio National Guard physician Robert Johnson, of Medina, who had previously deployed on medical missions in Desert Storm and the war in Afghanistan, said that if you travel to the mountains of Puerto Rico, “you can’t believe the amount of devastation. It looked like some of the villages had been hit with artillery.
“Literally, buildings are just blown away,” he added. “There aren’t many structures that survive a 150 mph wind.”
That’s why the Ohio National Guard is in Puerto Rico.
Because Hurricane Maria never really left.
It lingers in downed power lines that still lie along roadsides like dead black snakes leading from twisted and toppled electrical poles.
It crouches in piles of rubble and gaping rooftops with their former layers of corrugated metal littering the landscape in mangled strips of steel confetti.
Maria killed 55 people and possibly more in its aftermath from illness, injury and lack of accessible health care.
The residents endure, as the suffering and deprivation continues.
That’s why the 285th Medical Company (Area Support) are among about 200 other members of the Ohio National Guard who have joined more than 5,000 Guard members from 20 other states in disaster relief across Puerto Rico.
It’s been a busy year of hurricane recovery for the Ohio Guard, with support previously sent to Texas in the aftermath of Hurricane Harvey in August, and to Florida and the Virgin Islands following Hurricane Irma in September.
Some 12 Ohio National Guard units, representing 425 soldiers and airmen, have been involved in relief efforts dubbed Operation Scarlet Hurricane.
But in this 100-mile-long U.S. territory, “the level of destruction was unprecedented,” said Maj. Gen. Mark Bartman, Ohio Adjutant General. “The biggest needs have been clean water and logistics — being able to get food and water to outlying areas and more remote parts of the island.
“Health care is a big problem,” he added, “and most of the cell towers are down.”
The Ohio National Guard troops are “making progress every day, but it’s going to take a while for (Puerto Rico) to get back to any semblance of normalcy,” Bartman said. “They need all the help they pretty much can get.”
Ohio Guard units are providing aircraft for transportation of troops and relief supplies, plus such specialized gear as a mobile kitchen for first responders, a water purification unit, a “bed-down” (temporary housing) system, power generators and medical gear including X-ray machines and ventilators.
Guard units on the ground are supplying medical aid, transportation services and establishing communications links.
Ohio is providing aid through the Emergency Management Assistance Compact, a federal act allowing states to offer mutual aid in times of disaster or emergency. Though the requesting state (or territory) usually covers the costs, Bartman said the federal government has said it will pay for this recovery effort.
In delivering this assistance, Ohio’s Guard members said they have been uniformly greeted with thanks and appreciation by Puerto Ricans.
And at times, the benefits can work both ways as the Ohio soldiers discover things about themselves, and the resilience of the human spirit.
A Mission of Healing and Hope
The floor of a basketball arena, home of the Ponce Leones (Lions), is blanketed with hospital beds where members of the 285th, joined by medical staff of the U.S. Public Health Service and other government agencies, tend to those who aren’t sick enough to go to a hospital, but too ill or infirm to stay at home where they can’t get medical care.
More than two dozen patients usually are treated here on any given day.
They include Rosario, 55, who has medical issues requiring treatment with electrical machines. He has neither power nor water at home, nor a reliable way to call for help (given the extensive damage to phone communications on the island).
“That’s the scariest part, when you’re cut off from the rest of the world,” he said.
He calls the Guard members at the arena his “angels,” and said, “They’re very courteous, very patient with the patients, and the things that they do are beyond the call of duty sometimes.”
The 59 soldiers comprising the Ohio National Guard medical team, representing members of the 285th and other units, arrived in San Juan in early October to a capital city still darkened by a lack of power.
Initially, they stayed at an elections center where voting machines are stored, sleeping on cots and using makeshift showers created from tent tarps and garden hoses.
They moved to the Costa Bahia Hotel and Convention Center in Guayanilla, near Ponce — Puerto Rico’s second largest city with a population of nearly 200,000.
The hotel serves as a virtual United Nations of U.S. government agency hurricane relief workers including the U.S. Public Health Service, Army Corps of Engineers and National Disaster Medical System.
Guard members — representing doctors, nurses, medics and behavioral health specialists — are divided into two, 12-hour shifts for round-the-clock coverage at the basketball arena. Their efforts are augmented by Puerto Rican officials and volunteer medical university students.
The 285th has a diverse mission.
“We are supporting a field medical center. We are also providing outreach mission support where we go out into the local communities, pass out food and water, and provide medical treatment there,” said Maj. Bryanna Singleton, commander of the 285th and a registered dietician in Dayton.
“It’s pretty bad down here (in Ponce),” she said. “I know it’s a lot worse in the mountains, too. It’s very devastating to see.”
Dr. Robert Johnson, 55, said medical problems encountered by the unit include “some really acute things, like strokes and heart attacks, and then a lot of chronic things like Type 2 diabetes, hypertension, things like that.
“Some of them have been very sick,” he added. “Some of them just utilize us for medication refills (because) they don’t have access to their primary care physician.”
Medical teams in the field have encountered residents with injuries that have been untreated since the hurricane hit.
Johnson, a pediatrician at the Firelands Regional Medical Center in Sandusky, said the big difference between this mission and his prior deployment to combat zones is that “nobody’s shooting at us, which makes it a lot easier.”
But he also noted that when he got to Puerto Rico, “I just wasn’t prepared for the sheer devastation.”
Major Donald McHone, 44, of Beaver Creek, Ohio, worked in recovery efforts after Hurricane Katrina in 2005 and said the damage and loss of electricity was similar in both disasters, but the recovery in states along the Gulf Coast was easier because they could quickly truck in supplies, instead of trickling in on aircraft and ships.
McHone said one element of his current deployment caught him by surprise: “Just being able to see how people can be so grateful when they’re still having such a bad time,” he said. “I probably get more out of it than what I think I’m putting into it.”
Providing the Health, Love, Food and Water
A convoy of vehicles — rental cars and a military ambulance, escorted by police — arrived at small boxing gym in Palmas to set up a neighborhood medical clinic.
Tables and chairs were placed in the concrete-walled room with a leaking roof, to facilitate the more than 50 people expected to arrive during the three-hour visit.
Patients signed in and got a basic health examination. More serious cases were referred to tables staffed by National Guard and Public Health Service physicians. Workers at another table where a hand-letter sign “Rx” was taped to the wall handled prescription refills.
Boxes of food and cases of bottled water were available to those who needed it.
Temperatures in the 90s and high humidity turned the gym into a sauna of sweat, and workers were soon soaked.
But heat and rain didn’t deter residents from lining-up at the door. These included a man whose finger was painfully swollen from a surgical pin that had been inserted in a prior operation, and should have been removed weeks earlier.
He silently grimaced in pain, closing his eyes as a physician slowly pulled the pin from his finger.
He was comforted by Carmen Colon, 60, who had visited the clinic seeking stomach medication.
Colon said Hurricane Maria blew roof panels off the nearby Baru’s Sports Bar that she and her husband own, and where they live.
“I never thought it was going to be that bad. It was worse. It was like a tornado,” she recalled. “My house was shaking. Our street, it was like a river. I thought, ‘Oh my god, I’m living a nightmare.’
“I still cry a lot. I’m still having bad dreams at night.”
Since then, she said the neighborhood has been plagued by nighttime robberies, particularly theft of electrical generators, by brazen thieves taking advantage of the power outage.
But there is a silver lining in that dark cloud, with arrival of the medical clinic.
“Oh, it’s wonderful,” Colon said. “You can see the love that people have for each other.”
Carmen Cohen, 59, of Revere, Massachusetts, was visiting family in Puerto Rico and arrived just before hurricane hit.
She remembered three distinct sounds. “The storm sounded like a wolf, in-between a train, and at the end of the storm it was sounding like a tractor-trailer. Those were the most scary sounds I ever heard.
“I was sure I was safe in the house, but I was so sad for other people,” she added. “Especially when I see the roofs of their houses peeling apart. It was strange.”
Cohen had come to the clinic to guide a small team of medical workers to a home where a woman was housebound with her disabled daughter.
She described the National Guard’s presence as “Awesome. AWESOME! They’ve been helping those poor people here, and I’m so happy to see them.”
The feeling can be mutual.
“I love the people. Usually they are a very jovial, outgoing, just happy people,” said Capt. Richard Binks, 36, a a nurse at Riverside Methodist Hospital in Columbus who has previously vacationed in Puerto Rico.
“But because there has been a lot of devastation, it has been an emotional roller coaster for them, not knowing what tomorrow brings. There’s a lot of doubt.”
Binks said the language barrier has been a challenge.
“The interpreters have been wonderful, but for me, personally, I’ve wanted to communicate to them in the way that I would with anybody that speaks English,” he said. “And trying to instill that comfort, instill that relief, if you don’t have the right words to say, it’s sometimes difficult.”
Conversely, Binks said the best part of his work has been, “To see the sparkle in these people’s eyes again. The expression of hope has been re-instilled in these patients. They’re finally getting a sense of relief. Their loved ones are being taken care of.
“There is doubt,” he added, “but the least we can do here is provide that hope that tomorrow’s going to be a better day.”
Climbing to the Peaks of Medical Care
The mountain missions can be the most harrowing.
Steep narrow roads are still lined with the debris and shattered trees that once blocked them.
Mudslides are a risk when heavy rains hit areas already stripped of vegetation that once held the earth back.
Some bridges have been washed out. Power lines sag over the road in places. Houses built on hillsides can be cantered at dangerous levels, or simply gone.
But when the 285th traveled to a small community center in Jayuya to set-up a clinic, people found a way to get there.
Pauline Rivera, 43, brought her mother and two daughters to the clinic for a health check. She said while the hurricane was simultaneously scary and sad, the clinic helps ease the strain.
“A lot of help is coming, and I feel a little bit better,” she said.
Her mother, Patricia Rivera, said her positive attitude got her through the storm. “I take everything easy. I say something like that, and nothing bad happens,” she said.
“I LOVE the Guard,” she added. “I like what they do here.”
Louis Varela, 54, clutched a fistful of pill bottles representing prescriptions that needed to be refilled, as he waited in line at the clinic.
“I haven’t seen my doctor and his office is closed. I’m out of medication,” he said. “The way they’re working with the citizens is great.”
In one corner, a woman continuously sobbed while talking to a Puerto Rican social worker, part of the tapestry of suffering and need.
Among those responding to the need, Spec. Tessa Kolman said that as soon as she heard of the opportunity to volunteer for the mission to Puerto Rico, “I dropped everything and put myself on the list, because I needed to come. I just knew it.”
Kolman, 20, a nursing assistant from Marion, worked with a the team handling the initial physical exams at the clinic and said getting to know the patients and understand their struggles has been rewarding.
When asked if she felt like the Ohio Guard was making a difference, Kolman said, “I hope so. Absolutely.
“These people will tell you about their hometowns, and what that don’t have,” she added. “And how this (clinic) being here is such a vital resource to them, and without it, they wouldn’t get the care they need.”
It could have been worse.
Much, much worse, according to Sgt. Michael Mains, 30, who was living in Ohio when he joined the Ohio National Guard but now lives in Fort Thomas, Kentucky.
Prior to joining the Guard, Mains served in a Navy search and rescue unit, and was deployed to Haiti after the earthquake that killed more than 300,000 people in 2010.
There’s no comparison that can be made between conditions in Haiti and those in Puerto Rico, according to Mains.
Cities in Haiti were leveled. “It looked like an atomic bomb went off,” Mains said. “For those people it was Armageddon. It was the end of the world, and it looked like that.”
The sergeant is now a behavioral specialist, and on this mission he is assisting psychologists and social workers in dealing with the post-hurricane stress felt by some Puerto Ricans.
Mains said one little girl living in the mountains was still suffering from panic attacks after her house fell down a hillside during the hurricane.
“But she’ll make it,” he said. “She’s strong. It’ll be a story she tells her friends in college some day.”
Stress also can impact the National Guard troops in their mission, according to Mains.
But one lesson that Mains said he has learned in Puerto Rico is the resiliency of the 285th. “There is a constant flow of uncertainty, enough to bring soldiers down, but it has not happened to this unit,” he said.
The unit’s chaplain, Capt. Calebb Proehl, 29, of Mount Vernon, also said the soldiers’ morale has been strong during the mission that could come to an end, at least for these Guard members, on November 20. The unit will not be replaced, according to a guard spokesperson.
Part of that confidence may be due to a determination to help, and the rewards that result, according to Proehl.
“I think many of us coming down here really wanted to make quite an impact,” he said.
The rewards are seeing “the joy restored in some children up in the mountains, and seeing their parents smile as well. Seeing that little bit of joy, that little bit of hope, that silver lining, and that is extremely fulfilling,” said Proehl, who also helped coordinate religious support of civilians among local clergy.
Proehl said he also has been struck by the strength of Puerto Ricans recovering from the disaster.
“That’s been a thread that’s been all the way through this entire trip, is that we’ve been able to see the resiliency of the people,” the chaplain said.
Hurricane survivor Carmen Colon was asked what kept her going through the hardships.
Her grandchildren, she said.
But above all, “You’ve got to be strong,” she said. “You’ve just got to keep going.”