AAP Voices Blog

Editor’s note:
This is one of a series of “AAP Voices” posts to highlight the effect of climate change on children’s health.

My commute to Manati, a town located in the northwestern part of the island of Puerto Rico, was a time of relaxation away from the San Juan metro area. Those 30 miles of highway between tree-blanketed mountains and valleys were my escape from the urban traffic. Approaching Manati, I even glimpsed the deep blue hues of the Atlantic Ocean contrasting with the breathtaking pale, almost hypnotizing blue, of the Caribbean sky.

But on October 2, 2017, my trip to Manati was very different. That morning marked the thirteenth day after two monster hurricanes hit our archipelago. Maria passed over Puerto Rico just two weeks after Irma’s visit, and its force was unprecedented. According to weather experts, Hurricane Maria is considered one of the 10 strongest storms on record in the Atlantic Ocean and the worst in Puerto Rico’s history.

I am a pediatrician working on several environmental health research projects investigating the effects of chemicals found in air, soil, water, food, and personal care products on the development of infants and young children on the island. I love what I do, especially because through our work we can help entire at-risk communities improve their quality of life through environmental health education and community engagement activities.

That day in 2017, I began to see first-hand just how dramatically the environment affects our availability of safe water for families. My commute took me through an endless stretch of untold destruction. Of those majestic trees that filled the vast landscape surrounding the highway, what remained were piles of crumbled trunks and dry branches. All the way to Manati, it looked like a post-war scene, a surrealistic picture taken out from an apocalyptic movie: entire communities destroyed, houses with no roofs, and flooded streets.

Once I arrived to the office, I met with other members of the research team, which consisted of doctors, nurses and public health specialists. Two of our team members lost their homes, and all of us were living without electricity or tap water. We all had to struggle to find where to buy bottled water. Some of our members survived those first two days drinking water from contaminated rivers and lakes. This was despite news of a rise in cases of leptospirosis, a potentially deadly infection that is transmitted when people have contact with water or soil contaminated with urine from infected animals. They had no other option.

My home had also run out of water. One night, when a tank truck passed by our street selling water, we bought some in desperation. We had no idea when service would be restored. A couple of days later, we found out that this water was possibly collected from a Superfund site, a former industrial area so chemically contaminated that had to be closed by the federal government for cleaning and remediation.

Fast forward to November 1. Most homes on the island were still without water or electricity, and water safety became our mission. I was in the process of teaching participtants in our research projects how to assemble a home water microfiltration system. We were distributing the equipment needed to have 1 million gallons of clean water available at home for dozens of families with pregnant women or young children.

"You have to connect this piece to the bucket and screw it until it is completely tight,"I told one mother with a two year old who was expecting another baby. "That way, it’s sealed and the water won’t get lost," I continued. "Now, can you show me how to put this together yourself?"

“As pediatricians who see how harmful climate change is on health, we need to exert leadership and advocate for policies that recognize how closely our destinies are intertwined with the Earth’s.”

The young mother followed the steps perfectly as I explained to her that filters like these were used after the earthquakes in Haiti to clean all sorts of dirty water, even water from the streets.

"It will not filter out chemicals from the water, but it will remove away all bacteria, even leptospirosis," I told her. She smiled, letting out a sigh of relief knowing that "her children would have safe water to drink," she said.

What happened to families in Puerto Rico shows how climate change can severely impact the health and safety of entire communities. Meteorological science suggests that global warming will lead to sea level rise and an increase in tropical cyclone intensity, including associated rainfall. More powerful hurricanes accompanied by larger storm surges means more destruction and increase risk of exposures to contaminants in the aftermath of these disasters.

A warmer world has health implications beyond hurricanes. Ecosystems can get altered, with repercussions to the water and food supply. Increased frequency of flooding and droughts due to the the variability of rainfall patterns have been well documented. All these changes also enable insects carrying viral pathogens to extend their reach to new latitudes.

As pediatricians who see how harmful climate change is on health, we need to exert leadership and advocate for policies that recognize how closely our destinies are intertwined with the Earth’s. And we must be mindful about the most vulnerable among us, including children, pregnant women and unborn babies. All these effects are real and we must raise our voice to help people put cause and effect together and offer invdividual and societal solutions.

During that trip back home from Manati after showing the mother how to use a microfiltration system, my despair gave way to peace knowing that she and her family would now drink cleaner water. She was empowered, and so was I.