Building resilience through informal networks and community knowledge sharing: post-disaster health service delivery after Hurricane Maria

ABSTRACT

In September of 2017, Hurricane Maria made landfall in Puerto Rico, bringing widespread damage to public systems across the island, which included particularly devastating impacts to local hospitals and medical facilities. Health care organisations operating on the ground played an essential role in hurricane response efforts as they attempted to address the medical needs of vulnerable populations. However, minimal research has discussed how the provision of post-disaster healthcare rested on the knowledge and participation of local communities. This study aims to fill these gaps by exploring the ways in which health care workers relied on their relationships with informal community networks to navigate the post-disaster landscape and provide adequate health services. This study uses post-disaster response data collected in Puerto Rico, which includes interviews with private, non-profit, and university-affiliated health organisations, as well as community health centers and emergent health outreach groups. Findings from this study highlight the critical role informal networks, community outreach, and relationship building play in response work as organisations attempt to overcome the specific complexities and challenges of operating in the post-disaster context. Furthermore, our research illustrates how deficient government support and systematic failings shift the burden of resilience building onto community members and organisations.

KEYWORDS:

• Health care organisations
• informal networks
• knowledge sharing
• community engagement
• Puerto Rico
• Hurricane Maria

Acknowledgments

The authors would like to thank the kind, generous, and courageous Puerto Rican healthcare workers who shared their accounts of the hurricane and its aftermath. We also thank the Natural Hazards Center for their support, feedback, and funding of the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 All interviews were audio recorded, with the exception of one interview in which the two respondents requested not to be audio recorded. Eleven of these interviews were conducted individually, and eight were group interviews (with two people on average).

Additional information

Funding

This work was supported by Natural Hazards Center, University of Colorado Boulder: [Grant Number Quick Response Grant/QR288].