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Photos: A year after Hurricane Maria, Puerto Rican kidney patients fear death

In the beginning, 15 passengers flew from Vieques to the Puerto Rican mainland —refugees from Hurricane Maria. The storm had ruined the only dialysis centre on this tiny island of 9,000, their home. Without treatment, the kidney patients would die. But the thrice-weekly trips taking up to 12 hours each time, have taken a toll on these frail patients. Five have died in this past year from causes ranging from heart failure to cancer, but advocates insist that the very flights that keep the patients alive have hastened their deaths.

Updated on: Sep 20, 2018 9:27 AM IST

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1/11

42-year-old dialysis patient Sandra Medina waits inside a plane at the airport in Vieques, Puerto Rico. “It’s an injustice to have us like this” — flying back and forth for treatment — “when they can put a clinic here,” Medina said. Doctors amputated half her leg after an infection worsened months ago. A nervous flyer, she confided that sometimes she loses hope. “We go through a lot,” she said. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

42-year-old dialysis patient Sandra Medina waits inside a plane at the airport in Vieques, Puerto Rico. “It’s an injustice to have us like this” — flying back and forth for treatment — “when they can put a clinic here,” Medina said. Doctors amputated half her leg after an infection worsened months ago. A nervous flyer, she confided that sometimes she loses hope. “We go through a lot,” she said. (Carlos Giusti / AP)

2/11

The Vieques dialysis centre was located in the island’s only medical clinic. The building still stands, though it is heavily damaged and strewn with horse manure. Weeks after Hurricane Maria hit in 2017, health officials declared it contaminated and ordered it be demolished. Although flights to the mainland take just 20 minutes, the journey is far longer. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

The Vieques dialysis centre was located in the island’s only medical clinic. The building still stands, though it is heavily damaged and strewn with horse manure. Weeks after Hurricane Maria hit in 2017, health officials declared it contaminated and ordered it be demolished. Although flights to the mainland take just 20 minutes, the journey is far longer. (Carlos Giusti / AP)

3/11

The patients wake up before dawn, wait at the airport for the plane to arrive, clamour aboard and then, once they reach the mainland, wait for transportation to the clinic. There, they sit for four hours as their blood flows through a filter and returns cleansed. Then they repeat the same routine to get home, arriving about 12 hours after they started their day. “It’s exhausting,” Elias Salgado (pictured) said. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

The patients wake up before dawn, wait at the airport for the plane to arrive, clamour aboard and then, once they reach the mainland, wait for transportation to the clinic. There, they sit for four hours as their blood flows through a filter and returns cleansed. Then they repeat the same routine to get home, arriving about 12 hours after they started their day. “It’s exhausting,” Elias Salgado (pictured) said. (Carlos Giusti / AP)

4/11

“You don’t get used to this,” chimed in Edwin Alvarado (R), a 59-year-old dialysis patient who also has high blood pressure and had an open heart surgery five months after Maria. Like Salgado, Alvarado said he’d love to move to the US mainland and closer to a dialysis clinic, but he has nowhere to stay and cannot afford to leave Vieques. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

“You don’t get used to this,” chimed in Edwin Alvarado (R), a 59-year-old dialysis patient who also has high blood pressure and had an open heart surgery five months after Maria. Like Salgado, Alvarado said he’d love to move to the US mainland and closer to a dialysis clinic, but he has nowhere to stay and cannot afford to leave Vieques. (Carlos Giusti / AP)

5/11

56-year-old Salgado plays with his dog Farruko. Salgado has another reason to stay. He’s on Puerto Rico’s transplant list. “I could be called at any moment,” he said. Some of the patients knew each other before the storm; Vieques is a small island, with about 9,000 people. As months progressed, they began to feel like a small family, complete with quibbling, especially about those who complain too much. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

56-year-old Salgado plays with his dog Farruko. Salgado has another reason to stay. He’s on Puerto Rico’s transplant list. “I could be called at any moment,” he said. Some of the patients knew each other before the storm; Vieques is a small island, with about 9,000 people. As months progressed, they began to feel like a small family, complete with quibbling, especially about those who complain too much. (Carlos Giusti / AP)

6/11

Salgado’s doctor, Jose Figueroa, worries about the effects of such exhausting travel. He likens it to insisting that someone walk home after running a marathon. “Eventually those patients, who already are fragile, will keep worsening,” he said. A year of this, he said, was “unacceptable.” (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

Salgado’s doctor, Jose Figueroa, worries about the effects of such exhausting travel. He likens it to insisting that someone walk home after running a marathon. “Eventually those patients, who already are fragile, will keep worsening,” he said. A year of this, he said, was “unacceptable.” (Carlos Giusti / AP)

7/11

A nurse checks the blood oxygen saturation levels of dialysis patient Edwin Alvarado. Survivors of those who have died over the past year acknowledge that their loved ones were very sick, but they believe they need not have perished. Argeo Caraballo, 70, died of heart failure on February 13. “The trips were way too exhausting,” his daughter Gladys said. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

A nurse checks the blood oxygen saturation levels of dialysis patient Edwin Alvarado. Survivors of those who have died over the past year acknowledge that their loved ones were very sick, but they believe they need not have perished. Argeo Caraballo, 70, died of heart failure on February 13. “The trips were way too exhausting,” his daughter Gladys said. (Carlos Giusti / AP)

8/11

Paramedics wheel Sandra Medina to a plane at the airport in Vieques. At first the Federal Emergency Management Agency (FEMA) assumed responsibility, flying patients to San Juan. After a month, FEMA withdrew and non-profits picked up the bill. Since March, the Renal Council has been paying for travel and food. However, the council has said it will run out of money to do so by month’s end. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

Paramedics wheel Sandra Medina to a plane at the airport in Vieques. At first the Federal Emergency Management Agency (FEMA) assumed responsibility, flying patients to San Juan. After a month, FEMA withdrew and non-profits picked up the bill. Since March, the Renal Council has been paying for travel and food. However, the council has said it will run out of money to do so by month’s end. (Carlos Giusti / AP)

9/11

Argeo Caraballo’s burial site at the municipal cemetery in Vieques. Caraballo was one of the dialysis patients who died hoping the mobile unit that federal officials purchased to provide dialysis on Vieques would arrive after Hurricane Maria ruined the island’s dialysis centre. Officials have are yet to respond to why Vieques still has no dialysis centre. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

Argeo Caraballo’s burial site at the municipal cemetery in Vieques. Caraballo was one of the dialysis patients who died hoping the mobile unit that federal officials purchased to provide dialysis on Vieques would arrive after Hurricane Maria ruined the island’s dialysis centre. Officials have are yet to respond to why Vieques still has no dialysis centre. (Carlos Giusti / AP)

10/11

Patients prepare to board a plane at the airport in Vieques, that will take them to Ceiba Puerto Rico. Deputy Mayor Daisy Cruz said she is in constant communication with FEMA officials but receives limited answers. She said she has proposed rehabilitating an old pharmacy so it can be used for dialysis, but has not heard back from the company that ran the clinic. (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

Patients prepare to board a plane at the airport in Vieques, that will take them to Ceiba Puerto Rico. Deputy Mayor Daisy Cruz said she is in constant communication with FEMA officials but receives limited answers. She said she has proposed rehabilitating an old pharmacy so it can be used for dialysis, but has not heard back from the company that ran the clinic. (Carlos Giusti / AP)

11/11

Cruz cries as she denounces adverse conditions to which dialysis patients have been exposed. “Where is the conscience? Where is the humanity?” she asked, tearing up. “It’s always, ‘We don’t have the money, we don’t have the money, we don’t have the money.’ But they’re putting at risk lives that we could prolong.” (Carlos Giusti / AP)

Updated on Sep 20, 2018 9:27 AM

Cruz cries as she denounces adverse conditions to which dialysis patients have been exposed. “Where is the conscience? Where is the humanity?” she asked, tearing up. “It’s always, ‘We don’t have the money, we don’t have the money, we don’t have the money.’ But they’re putting at risk lives that we could prolong.” (Carlos Giusti / AP)

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