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Mold is blanketing Puerto Rico making it difficult for many to breathe.

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The unfolding humanitarian crisis in Puerto Rico after Hurricane Maria barreled over the island is only getting worse. Alarm bells are being rung from humanitarian organizations on the ground that the deteriorating conditions are seriously impacting human health and survival. Warnings from the front lines are summarized in the excerpts below.

Coco McCabe writes for OXFAM.

“It’s an emergency that a month in should not be an emergency--but it is,” said Thompson, presenting a series of real-life scenarios that Puerto Ricans have been grappling with since driving rain and winds of 155 miles per hour  took down the island’s entire electrical grid on Sept. 20.  Without electricity, a great deal of daily life grinds to a halt: there’s no light at night,  no fans or air conditioners to cool sweltering rooms, no easy way to charge phones or access the internet, no reliable way to keep hospitals running--the list goes on.

What would you do, Thompson asked, if your elderly mother, wheel-chair bound and desperately needing food and water, was stuck on the 17th floor of an apartment building in San Juan with no working elevator?

Or, what if the hurricane had drenched everything inside your house including all the mattresses, forcing you and your children to sleep on the floor where rats could be scampering? Or what if you lived in the countryside, stuck on the far side of a collapsed bridge, and you had no way to get drinking water because the storm knocked out your community’s delivery system? There’s no bottled water anywhere and a relief convoy hasn’t visited in days. What would you do?

Not everyone is suffering, Thompson pointed out. Those with money have options: They can get a hot meal in a restaurant; they can buy fuel for their cars and generators; they can purchase dry sheets and towels for their homes--and their homes, better built to begin with, may still have their roofs.

“It’s hard to describe the complexity of it,” said Thompson. “Parts of San Juan look normal; parts look ravaged.”

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According to the National Institute of Health (Clinical Microbiology Rev. July 2003; 16(3):497-516. Mycotoxins. By J.W.Bennett and M. Klich), “Mycotoxins are secondary metabolites produced by microfungi that are capable of causing disease and death in humans and other animals.  Mycoses range from merely annoying (e.g., Athlete’s Foot) to life-threatening (e.g., invasive Aspergillosis). Primary pathogens affect otherwise healthy individuals with normal immune systems. Opportunistic pathogens produce illness by taking advantage of debilitated or immune-compromised hosts……  The majority of human mycoses are caused by opportunistic fungi.” “Mycoses are frequently acquired via inhalation of spores from an environmental reservoir. Skin contact with mold-infested substrates and inhalation of spore-borne toxins are also important sources of exposure.” (Bennett and Klich, ibid). Diseases associated with inhalation of spores include toxic pneumonia, hypersensitivity pneumonia (characterized by inflammation of the lungs which can lead to scarring of the lungs, an irreversible condition that decreases lung capacity), sinusitis, tremors, chronic fatigue syndrome, kidney failure, biofilm, hair loss, skin conditions, vision disturbances, neurologic disturbances, diarrhea, nausea, vomiting, internal hemorrhaging, and abnormal liver levels. Exposure to mold, according to the Florida Department of Health, can cause cognitive problems such as memory loss and mood swings. In some individuals, these can lead to depression, fatigue and loss of interest in everyday activities. Mycotoxins can cause sleep disturbances and if left untreated, can lead to neurological problems such as impaired balance and difficulty walking.

“Tarps are desperately needed right now,” said Thompson, noting that one rural woman she encountered had relied on her sister in the Dominican Republic, where more than 40 percent of the population lives in poverty, to send her one. “Some kind of lighting system is badly needed. There are all kinds of things you can’t get--insect repellent, [a type of ] batteries.”

But with the rainy season here, tarps top the list for some community leaders who are doing all they can to  help ensure people have shelter.  Thompson described the efforts of one woman who has been trying to get tarps for about 800 homes in different communities outside of San Juan: The woman approached the Federal Emergency Management Agency, or FEMA, which sent her to speak to the mayors of the communities. The mayors didn’t have tarps, so she went back to FEMA. No luck again. So next she called the tarp manufacturing companies in the US, and hit a dead end there, too.

“She has been up and down for these communities and has not been able to get these tarps,” said Thompson.

Those efforts are playing out against a new worry for families whose homes have been exposed to the elements: mold.

“A lot of times in hurricanes people forget to talk about just how hard it is to clean out your house, and the mold,” said Thompson. “It’s an increasing problem. People are just beginning to realize it.” Chlorine is what people need to try and tackle the problem, but the supplies are restricted.

“You need a whole kit to take mold off,” said Thompson. “You need to educate people about that. And so how do you do that when there is no communication?” She said the public health department will need to organize a full effort to address the mold issue.

“It seems everywhere you come up against another insurmountable problem," Thompson added.

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