Marielly Fuentes Torres, 44, slid off a road and into a cliff as she was driving to see her mother, says her husband Gabriel Díaz. A clean-up crew that had cleared a Maria-induced landslide earlier that day left loose dirt behind, which turned into mud. Road workers failed to warn drivers of the dangerous conditions or to install protective barriers to replace the pine trees that, before Maria, had served as a buffer between the highway and the cliff. “Directly or indirectly, she died as a result of Maria and the inaction by the Puerto Rican government and FEMA,” said Díaz.
The official cause of his wife’s death, however, is simply “serious corporal trauma.”
Sadly, these kinds of inconsistencies aren’t limited to what’s happening in Puerto Rico. The Center for Disease Control has guidelines about how disaster-related deaths should be recorded but it also says that how it’s handled can vary wildly from state to state. The most recent guidance was issued in October of 2017, when Puerto Rico was in the midst of dealing with its trauma from Maria. Interestingly, the guidance does state that a note should be made on death records indicating when a person has died from a natural disaster—directly or indirectly.
That includes people who drowned from a flood, for example—that would be a direct death—and people who died because of disruptions caused by that flood, such as closed hospitals. Other situations that qualify as an indirect death, according to the CDC’s guide, read as a checklist of the conditions that led to deaths after Maria as described by the survey respondents: Power outages, blocked-off roads, displacement, property damage, personal loss, stress.
One way of knowing is asking this question, per the CDC: “But for the disaster (hostile environment), would the person have died when he/she did?” If the answer is no, the death certificate should name the disaster and link it to the death.
Though this information has relevance and importance for maintaining accurate records, public safety and disaster preparedness, there is no real enforcement of these guidelines. Add to that the island’s government that remains in chaos and a disorganized health system in crisis and that explains part of what is occurring in Puerto Rico. The government remains cagey about getting an accurate and official death toll count—saying that they are waiting the results from a study they originally claimed would be ready sometime in May.
Meanwhile, experts say that it is impossible to obtain an accurate count of disaster-related deaths without hearing stories from survivors. Rebecca Yore, a director at the UK-based non-profit Rescue Global said: “To truly understand a disaster like Maria, you have to look at the personal stories behind those numbers.” Survivors not only can give a more accurate accounting of storm-related deaths, they can also help organizations and governments identify issues and vulnerabilities that impact certain populations.
It is unlikely that we will know anytime soon how many people died because of Hurricane Maria. But researchers and journalists are doing the important work to make sure that there is a more accurate count and that survivors stories do not get lost. In an era where the press is under attack by the current administration and its allies, the journalistic efforts in Puerto Rico demonstrate exactly why this kind of investigative journalism is so important to our democracy and to our health, safety and well-being.