Suchergebnisse

This thesis seeks to illuminate the economic, cultural and social subjugation of Puerto Rico, and its people, through the stripping of personal and political self-determination imposed by U.S. colonization. This research explores historic examples of Puerto Rican perseverance and analyzes psychologically protective factors supporting survivorship and resilience, such as familism and ontological security. The effects of Hurricane Maria on mental health are highlighted in the research, as is the correlation between a lack of electrical power and adverse health/wellness outcomes. Models for collective liberation and social justice are discussed and exemplified through the case study of a march that took place in Boston, MA on the one-year anniversary of Hurricane Maria. The concepts of the shock doctrine and disaster capitalism are explained and connected to various historic moments in Puerto Rico, including after Hurricane Maria. Bomba and Afro-Caribbean dance/rituals are explained and connected to practices in liberation. The current absence of Bomba and Afro-Caribbean dance in the dance therapy field are used to exemplify areas of growth necessary for making dance therapy more inclusive and increase the field's growth in cultural humility. This thesis also incorporates analysis of cultural competence and systemic oppression throughout and concludes with a call for dance therapists to be more active in advocating for social justice through their individual and clinical practice.

This study explains why and how Puerto Rican activists responded effectively to the crisis in the aftermath of Hurricane Maria in 2017. By relying on a structural approach, this study analyzes the local institutional environment. Using the seamful work framework, it examines activists' practice to reveal activists' relation with their official state infrastructure and their interactions with said infrastructure before and after Maria. Using semi-structured interviews, observations, and publicly available documents, this study shows that activists navigate the state's unequal infrastructure by building their infrastructures, called alternative sociotechnical infrastructures, which consist of a set of heterogeneous assortments of actors, organizations, and technologies to address state-driven inequality and natural disasters. Activists do not work to restore existing state infrastructures, instead, they deploy their expertise in their communities to address many of the challenges brought on by disasters. This study emphasizes a bottom-up approach, highlighting local actors' agency by focusing on the convergence of their knowledge, organizations, and Information and Communication Technologies. Moreover, this research proposes that state-community disconnect is rooted in neoliberal and colonial measures and cautions against considering disasters as opportunities to start anew. Finally, this research proposes new possibilities to plan bottom-up relief efforts that acknowledge the role of civil society and activists.

This book deals with the immediate effects of, and response to, Hurricane María on the social, ecological, and technological systems (SETS) of Puerto Rico. The SETS approach to analyzing hurricane effects places into historical context the role of social and technological factors, and compares social and ecological resilience on the same temporal scales. Written from the perspective of a Puerto Rican scientist who experienced Maria's wrath first-hand, the book uses extensive empirical knowledge of the ecological effects of hurricanes on Caribbean forests and combines that knowledge with a detailed analysis of the effects of Hurricane María on the social and technological fabric of Puerto Rico. The comparison suggests that the effects of extreme events are dictated not only by the strength of the physical event, but also by the conditions of affected SETS at the time when the event exerts influence over them. Moreover, SETS have historical legacies that influence how resilient they can be when affected by an extreme event. Therefore, preparation and response to extreme events require an integrated social, ecological, and technological effort, known as the SETS response. The SETS response requires an understanding of the energetics of extreme events and their effects on the economy, which in turn determines social and technological resilience. Hurricane María demonstrated that the social and technological systems of Puerto Rico were not adapted to dealing with extreme events, in contrast with the ecological systems, which were. Hurricane María's effect on Puerto Rico can be used as an example from which valuable lessons emerge for making SETS more adaptable and resilient to extreme events.

Introduction -- Puerto Rico's Health and Social Services Sectors Before the Hurricanes -- Damage and Needs Assessment -- Themes for Recovery and Courses of Action -- Implementation Considerations -- Appendix A: Courses of Action -- Appendix B: Health and Social Services Sector COAs -- Appendix C: COAs from Other Sectors Included in the Health and Social Services Portfolio -- Appendix D: Health and Social Services Portfolios -- Appendix E: Plan Development.

Background: Every year, Puerto Rico faces a hurricane season fraught with potentially catastrophic structural, emotional and health consequences. In 2017, Puerto Rico was hit by Hurricane Maria, the largest natural disaster to ever affect the island. Several studies have estimated the excess morbidity and mortality following Hurricane Maria in Puerto Rico, yet no study has comprehensively examined the underlying health system weaknesses contributing to the deleterious health outcomes. Methods: A qualitative case study was conducted to assess the ability of the UPR health system to provide patient care in response to Hurricane Maria. An established five key resilience framework and inductive analysis was used to identify factors that affected health system resilience. Thirteen Emergency Medicine Physicians, Family Medicine Physicians, and Hospital Administrators in a University of Puerto Rico (UPR) Community Hospital were interviewed as part of our study. Results: Of the five key resiliency components, three domains were notably weak with respect to UPR resiliency. Prior to the Hurricane, key personnel at the UPR hospital were unaware of the limited capacity of back-up generators at hospitals and were ill-prepared to transfer ICU patients to appropriate hospitals. Post Hurricane, the hospital faced self-regulation challenges when triaging the provision of Hurricane-related emergency services with delivering core health services, in particular for patients with chronic conditions. Finally, during and after the Hurricane, integration of patient care coordination between the UPR hospital ambulances, neighboring hospitals, and national and state government was suboptimal. The two remaining resiliency factors, addressing diverse needs and system adaptiveness in a time of crisis, were seen as strengths. Conclusions: Hurricane Maria exposed weaknesses in the Puerto Rican health system, notably the lack of awareness about the limited capacity of backup generators, poor patient care coordination, and interruption of ...

"In September 2017, Puerto Rico was struck by two major hurricanes—Irma and Maria—that intensified existing challenges in Puerto Rico's health and social services infrastructure. In the aftermath, the government of Puerto Rico created a long-term recovery plan built on an evidence-based assessment of the damage from the hurricanes and the ongoing needs across Puerto Rico. Development of the recovery plan was supported by the Federal Emergency Management Agency, other federal agencies, local stakeholders, and analysis from the Homeland Security Operational Analysis Center (HSOAC), operated by RAND Corporation under contract with the U.S. Department of Homeland Security. HSOAC research provided the foundation for the 31 courses of action in the recovery plan addressing the health and social services sector. These actions are a mix of social, governmental, fiscal, and economic policies and reforms. This collection of actions presents an opportunity to build a more resilient health and social services infrastructure and regional health care networks to ensure reliable access to services, promote health and well-being, and more efficiently and effectively respond to public health crises and future disasters. The actions span the areas of health care, public health and emergency preparedness, environmental health, mental and behavioral health, and social services. The damage and needs assessment and courses of actions cover four major themes: building system capacity to respond both during disasters and routine times; strengthening the health and social services workforce; strengthening support services for at-need populations; and creating health-promoting communities.