Failing healthcare on the island of Vieques

Thousands of concrete blocks lay lined up, side by side, on the edges of Luis Muñoz Rivera plaza in Vieques, an island in Puerto Rico. Each block is a symbol of the foundational block for the hospital that Vieques needs.

By Arnab Mondal
Medill Reports

Thousands of concrete blocks are lined up, side by side, on the edges of Luis Muñoz Rivera Plaza in Vieques, a tiny island in Puerto Rico. Some of the blocks are dyed with color, and most have names scribbled on them.

At first glance, the colorful blocks, red ribbons and heart decorations on the stage at the end of the plaza seem like part of a festival. However, the sheer number of names on the blocks is reminiscent of memorials. At first glance, one might wonder if the names on the blocks belonged to victims of Hurricane Maria. Not only did Vieques suffer mass destruction due to the hurricane, but the island almost entirely lost contact with the outside world for about two weeks.

After Maria, Vieques was left without proper water and power supply for a long time. Combined with the flooding of its only hospital, the Centro de Diagnostico y Tratamiento de Vieques, the resulting death toll on the Viequenses was severe. Hence, the idea that the local community might be building memorials to the victims hardly seems like a stretch.

However, a few of the blocks stand out from the rest. These blocks don’t have any names scribbled on them. Rather, each one contains only a single letter. Put together, they spell out messages like “Hospital” or “Niños Muriendo” (“Children Dying”).

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The Luis Muñoz Rivera plaza in Vieques, decorated with banners and ribbons. (Arnab Mondal/MEDILL)

This initiative was started after Jaideliz Moreno Ventura, a 13-year-old girl living on Vieques, died due to lack of proper healthcare early this year. Geisha Rosa, who started this initiative with her father Geigel Rosa Cruz, said that the names on the blocks belong to the people who set down the blocks on the plaza, and the goal of this entire project is to demand the construction of a new hospital in Vieques.

“Each block here is a symbol of the foundational block for the hospital we need,” Geisha said. “People buy a concrete block from the local vendor, which costs only 80 cents, and they set it down in the plaza with their names on it as a collective demand for a proper hospital.”

She also said that the goal was to reach 10,000 blocks. As of now, there are 7,400 blocks on the plaza.

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Geigel Rosa Cruz (left) and his daughter Geisha Rosa (right). (Arnab Mondal/MEDILL)

A deeper inspection of the plaza would also reveal that the decorations on the stage were not from any festive celebration. They were, in fact, ribbons commemorating the fight against cancer. The banners around the stage had messages like “Hospital para Vieques ya” (Hospital for Vieques now) and “Vieques exige un hospital digno; a lucha continua…” (Vieques demands a decent hospital; the fight continues…).

Cancer rates in Vieques have been disproportionately higher than the rest of Puerto Rico. Yet, Vieques has no proper facility to deal with cancer. Vieques’ old hospital has been shuttered ever since 2017.

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The Centro de Diagnostico y Tratamiento, Vieques’ old hospital. (Arnab Mondal/MEDILL)

The only operating hospital in Vieques, Centro de Salud de Vieques, was originally the only emergency shelter on the island during Hurricane Maria; it was later turned into a public community health center. The health center, however, has one emergency room, no pharmacy, and one birthing room with spotty air conditioning.

There are a handful of primary care doctors on the island, but no specialists who can treat the growing number of patients undergoing dialysis. Viequenses in need of dialysis or chemotherapy have to travel to San Juan for treatment, which is an 80-mile trip over sea and land. As such, the people of Vieques have been petitioning the government for a proper hospital for years.

“As soon as you lay the first stone for the hospital, we’ll move all these blocks,” Geisha said. “But the more you make us wait for the hospital, the more blocks we’ll bring in.”

Vieques is also home to some of the highest sickness rates in the Caribbean. The residents blame the U.S. Navy. For over 60 years, the U.S. Navy used Vieques as a test bombing range and site for military-training exercises. The Navy also admitted to using heavy metals and toxic chemicals like depleted uranium and Agent Orange on the island but has denied any link between their presence and the health conditions of the people who live there.

While many residents feel strongly that the contamination left by the Navy is to blame for countless health problems, the government requires a particular standard of causal evidence before it will provide compensation or demand stricter cleanups of pollution. Yet independent groups cannot necessarily provide that proof because the federal government still owns the land previously occupied by the military and controls access to it.

The Navy stopped its testing in Vieques in 2003, after an intense international protest movement following the accidental bombing death of a civilian contractor on the base.

Under the Navy’s withdrawal agreement signed in 2003, it was also tasked with cleaning up any unexploded ordnance remaining from decades of weapons tests in and around Vieques. However, the cleanup process involves detonating the unexploded shells, which ironically is in direct violation of the 2003 agreement.

Myrna Pagan, the spokesperson of Vidas Viequenses Valen (Vieques Lives Matter), a movement inspired by the Black Lives Matter, said that the community has been regularly organizing protest demonstrations against the remediation process outside the U.S. Navy’s Restoration Advisory Council building.

“After six decades of bombardment and contamination, Vieques denounces this practice and we demand the use of existing alternatives for the cleaning of our lands and sea,” she said.

The presence of toxic chemicals within the unexploded ordnance has made the detonation of these shells even more concerning for the community. In July 2017, two such explosions close to the community released toxic chemicals into the air. The community was neither notified about the detonations nor advised of any precautionary measures they could take. The Navy claims that the cleanup process is safe for the community. Monisha Rios, an army veteran and activist living in Vieques, however, doesn’t trust them.

“An organization that is accused of so many war-crimes, yet remains self-policed, cannot be trusted,” she said.

The people of Vieques also accuse both the federal government and their local government of long-standing neglect, describing their small island as “a colony of the colony” of Puerto Rico.

Geisha’s father, Geigel, said that while every politician talks about building a hospital during their electoral campaigns, nobody acts on it. “We don’t trust the government,” Geigel said, “They lie to us every time.”

Another banner on the stage read, “Ni una vida mas! Justicia para Jaideliz” (Not one more life! Justice for Jaideliz). Jaideliz Moreno Ventura, the 13-year-old girl who died due to lack of proper healthcare, first showed flu-like symptoms in early January. With no specialist doctor on the entire island of Vieques, Jaideliz’s parents had to take her to a hospital on the main island for observation, a two-hour journey away that includes a ferry and a car ride. But after she tested negative for influenza, they returned to Vieques

On the morning of January 12, however, Jaideliz began convulsing and had difficulty breathing. The family rushed her to the Centro de Salud, but the facility didn’t have a respirator. Doctors had to fly her to a main island hospital in an air ambulance while family members were asked to assist with manually pumping oxygen into Jaideliz. Jaideliz, however, passed away before they could make it to the hospital.

Jaideliz’s mother, Jessica Moraima Ventura Perez, blamed the government’s negligence for her daughter’s death. “She could have been saved,” she said, “My daughter didn’t just die; she was murdered by the system.”

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Jaideliz Moreno Ventura, a 13-year old girl who died in Vieques. (Courtesy Jessica Moraima Ventura Perez, Jaideliz’s mother)

The cost of replacing Vieques’s old hospital was estimated at $70 million. However, the Federal Emergency Management Agency (FEMA) did not agree with that figure and reassessed the grant with the Central Office of Recovery, Reconstruction and Resiliency (COR3) to reach a preliminary agreement of $46 million.

However, it was only after the young girl’s death that FEMA finally approved $39.5 million in federal funding to build a new hospital in Vieques.

“It is tragic that this funding was not released until after we lost one young life due to inadequate medical service on Vieques,” said Rep. Nydia Velázquez (D-NY), one of the few lawmakers who had been pushing for aid in Congress for a new Vieques hospital for months. Velázquez had also invited Ventura Perez to speak at the State of the Union last January.

Velázquez accused the Trump administration of neglecting the needs of Puerto Rico. “The delay in restoring health services on Vieques is symptomatic of how the Trump Administration has so callously treated Puerto Rico, first after Maria, and now, following the earthquakes,” Velázquez said.

Even after FEMA’s approval of the funding, Vieques won’t get a new hospital anytime soon. Vieques mayor Víctor Emeric said it’ll take four years before the new hospital opens. “Many bad things can happen for this community within these three to four years, but really that is how long it will take to build the hospital,” Emeric said in an interview with Radio Isla.

Ventura Perez has been organizing weekly vigils at the same Luis Muñoz Rivera Plaza every month to commemorate the death of her daughter as well as to demand justice for all those who have died for the lack of proper healthcare in Vieques.

“My family has suffered an unspeakable loss,” said Ventura Perez, “My daughter did not receive the appropriate medical services that could have saved her life when she needed it the most. Her death at such a young age, will not be in vain. We will make sure of that”.

She also said that the people of Vieques deserved an explanation of why the funds for a proper health center have taken so long to be approved and disbursed. The people also need to know why the existing health center does not have the proper equipment, medicines and protocols.

“We demand a dignified hospital, with medical equipment and supplies,” Ventura Perez said, “So that no other mother will have to go through what I am dealing with now.”

Arnab Mondal covers social justice at Medill. You can follow him on Twitter at @arn_mondal.

Photo at top: Thousands of concrete blocks are lined up, side by side, on the edges of Luis Muñoz Rivera Plaza in Vieques, an island in Puerto Rico. Each block is a symbol of the foundational block for the hospital that Vieques needs. (Arnab Mondal/MEDILL)