Community Resistance as Public Health Activism in Puerto Rico

2020 ◽  
Vol 110 (10) ◽  
pp. 1454-1455 ◽  
Author(s):  
Carlos E. Rodríguez-Díaz
Author(s):  
Mark E. Keim ◽  
Laura A. Runnels ◽  
Alexander P. Lovallo ◽  
Margarita Pagan Medina ◽  
Eduardo Roman Rosa ◽  
...  

Abstract Objective: The efficacy is measured for a public health intervention related to community-based planning for population protection measures (PPMs; ie, shelter-in-place and evacuation). Design: This is a mixed (qualitative and quantitative) prospective study of intervention efficacy, measured in terms of usability related to effectiveness, efficiency, satisfaction, and degree of community engagement. Setting: Two municipalities in the Commonwealth of Puerto Rico are included. Participants: Community members consisting of individuals; traditional leaders; federal, territorial, and municipal emergency managers; municipal mayors; National Guard; territorial departments of education, health, housing, public works, and transportation; health care; police; Emergency Medical Services; faith-based organizations; nongovernmental organizations (NGOs); and the private sector. Intervention: The intervention included four community convenings: one for risk communication; two for plan-writing; and one tabletop exercise (TTX). This study analyzed data collected from the project work plan; participant rosters; participant surveys; workshop outputs; and focus group interviews. Main Outcome Measures: Efficacy was measured in terms of ISO 9241-11, an international standard for usability that includes effectiveness, efficiency, user satisfaction, and “freedom from risk” among users. Degree of engagement was considered an indicator of “freedom from risk,” measurable through workshop attendance. Results: Two separate communities drafted and exercised ~60-page-long population protection plans, each within 14.5 hours. Plan-writing workshops completed 100% of plan objectives and activities. Efficiency rates were nearly the same in both communities. Interviews and surveys indicated high degrees of community satisfaction. Engagement was consistent among community members and variable among governmental officials. Conclusions: Frontline communities have successfully demonstrated the ability to understand the environmental health hazards in their own community; rapidly write consensus-based plans for PPMs; participate in an objective-based TTX; and perform these activities in a bi-lingual setting. This intervention appears to be efficacious for public use in the rapid development of community-based PPMs.


2003 ◽  
Vol 10 (suppl 1) ◽  
pp. 225-245 ◽  
Author(s):  
Julie H. Levison

From biblical times to the modern period, leprosy has been a disease associated with stigma. This mark of disgrace, physically present in the sufferers' sores and disfigured limbs, and embodied in the identity of a 'leper', has cast leprosy into the shadows of society. This paper draws on primary sources, written in Spanish, to reconstruct the social history of leprosy in Puerto Rico when the United States annexed this island in 1898. The public health policies that developed over the period of 1898 to the 1930s were unique to Puerto Rico because of the interplay between political events, scientific developments and popular concerns. Puerto Rico was influenced by the United States' priorities for public health, and the leprosy control policies that developed were superimposed on vestiges of the colonial Spanish public health system. During the United States' initial occupation, extreme segregation sacrificed the individual rights and liberties of these patients for the benefit of society. The lives of these leprosy sufferers were irrevocably changed as a result.


Author(s):  
Jessica M. Gordon ◽  
Deidre Orriola ◽  
Mary Unangst ◽  
Federico Gordon ◽  
Yazmin E Rodriguez Vellon

AbstractIntroduction:Describe the lived experience of a grassroots, nongovernmental disaster medical team (DMT) through a research lens and share practical lessons learned based on the DMT’s experience to support and inform future response teams.Method:Forty-five days after Hurricane Maria, a nongovernmental DMT provided primary medical care by means of community-based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team’s daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis.Results:Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions, such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions.Conclusion:Our nongovernmental DMT displayed similar characteristics demonstrated by federal DMTs post-natural disaster. Several strategic lessons learned emerged from the public health intervention important to future nongovernmental DMTs.


Addiction ◽  
2004 ◽  
Vol 99 (11) ◽  
pp. 1477-1478 ◽  
Author(s):  
JIM MCCAMBRIDGE

2013 ◽  
Vol 16 (7) ◽  
pp. A714 ◽  
Author(s):  
H.K. Yang ◽  
M. O’Brien ◽  
J. Chen ◽  
J. Grabenstein ◽  
E. Dasbach

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