Maria's smallest victims: In Puerto Rico, children's mental health a growing concern

OROCOVIS, Puerto Rico — Children in this mountain hamlet have seen roofs blown off their homes, endured weeks of cold dinners and hot nights and witnessed loved ones die in their living rooms.  

Six weeks after Hurricane Maria roared through Orocovis on its deadly path through Puerto Rico, local leaders here fear the psychological effects of the storm on children will be long-lasting and hard to erase.

“Many of them don’t yet understand the impact,” Orocovis Mayor Jesús Colón Berlingeri said. “They don’t understand why their house doesn’t have water, why their house doesn’t have power, why it no longer has a roof.”

He added: “They need help.”

Mental health is becoming a growing concern for disaster and Puerto Rican officials. Maria, which landed here Sept. 20, was the most devastating storm to hit the island in 70 years, killing more than 50 people, displacing thousands and upending the lives of Puerto Rico’s 3.4 million inhabitants.

Children who experience destructive storms are often the most vulnerable to long-term mental health effects, said Irwin Redlener, head of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health and president of the Children’s Health Fund.

A study Redlener led after Hurricane Katrina in the Gulf found that one-third of children in that disaster reported to have at least one mental health problem, but fewer than half of their parents were able to access professional services. Children post-Katrina were also 4-1/2 times more likely to have serious emotional disturbances than those not affected by the disaster, the study showed.

Maria may spur even more issues, since the storm affected virtually the entire island and many family members have been so busy securing basic needs, such as food and water, that children’s needs may be overlooked, Redlener said. Most schools have been closed since the hurricane hit six weeks ago, though more are expected to reopen this week, returning some normalcy to youngsters’ lives.

The U.S. Department of Health and Human Services and local groups such as the Ponce Health Sciences University have deployed some mental health services to impacted areas, though much more is likely needed, Redlener said.

“There’s going to be a mismatch of resources and need,” he said. “It’s really important that people go in and help families manage and deal with this massive trauma that has occurred.”

In Orocovis, with federal aid slow to reach the remote mountain town, local educators accepted an offer from Connecticut-based Save the Children to launch a temporary child care facility in a shuttered Catholic school. About 154 children ages 4 to 15 signed up and spent each morning, from 8 a.m. to noon, the past two weeks surrounded by teachers, social workers and other students, said Eugenio Soto, an educator and program coordinator.

The students at first were withdrawn and kept to themselves, he said. “It’s like they had something inside and they didn’t want anyone to know about it,” Soto said.

Slowly, through programs designed to verbalize thoughts, the students began sharing their experiences: How their house lost a roof or their family was displaced, he said. One student was upset that school supplies had blown away in the storm. They began talking more. “They could see that we were all going through the same thing, but it hasn’t been the end of the world,” Soto said.

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Valeria Gonzalez, a buoyant, smiling 8-year-old, said she misses school and enjoys playing with her friends in the temporary school’s big concrete patio. During Maria, Valeria and her family gathered at her grandmother’s house to ride out the storm. But when that home started to flood, the family rushed to her aunt’s house in the middle of the hurricane.

“We had to go fast because the hurricane was blowing hard and raining,” she said. “When we entered the house, we turned on the generator and they made us hot chocolate.” The next day, the family peeked outside to see devastation everywhere, including a relative’s home that was completely destroyed except for the bathroom.

“Everyone was shocked,” Valeria said. “It was terrible.”

About 20 minutes farther up the mountain from the school, Angel Luis Vazquez, 46, rode out the storm in his small, two-story home with wife Marta, daughter Coral and his father-in-law, Teodoro Colón Rodriguez, 82, who was recovering from a stroke and bedridden. 

The storm mauled through the home's second story, tearing off most of the roof and splintering walls as the family huddled in the ground floor. Rodriguez died during the storm, and it took three days for local authorities to reach the home and remove the body. Coral seemed most affected by the ordeal, Vazquez said.

“It’s been sad for her. She didn’t expect this,” he said. “I didn’t know how to explain the situation to her. I was worried about the wind, making sure no more water got in the house, defending us as best I could. It wasn’t easy.”

Since the storm, Marta’s blood pressure has shot up and Vazquez said he’s worried how his daughter is handling everything, since she was close to her grandfather. They could use outside help, he said.

“We need people to check on us, to see how we’re doing emotionally,” Vazquez said. “Because we’re not well.”

Follow Jervis on Twitter: @MrRJervis.