The urgency to correct the inefficiency and negligence associated with the loss of thousands of lives in Puerto Rico after Hurricane Maria, as well as the lack of transparency and akcnowledgement of the death toll magnitude, are among the lessons of the late official confirmation that the death toll far exceedeed what was recognized until this week.

These and other leasons should deeply affect the professional and moral fiber of everyone responsible for protecting health and life, and for carrying out legal registration when death occurs. Correcting the failures that contributed to the loss of so many people opens the door to begin healing the deep wounds of pain and outrage.

The George Washington University Milken Institute School, together with University of Puerto Rico experts, established that the excess deaths between September 2017 and February 2018 was between 2,658 and 3,290, with an average of 2,975. This estimate replaces the official 64 death toll, despite the fact that there were many indications that this number was far below the actual death toll.

 The study emphasizes that poverty and institutional abandonment contribute to death. The emergency had a disproportionate impact on vulnerable population. The government was absent, away from the emergency and survival in our communities. It is urgent to break down structures that reproduce inequality and poverty, and of integrating communities when dealing with problems.

 The inadequate federal response joins the local incompetence. The investigation shows that most of these victims died during the disaster response period. Nearly 900 people more than usual died between January and February - more than three months after the storm. They lacked electricity, communications and adequate medical assistance. Researchers warn that there are more -not counted- since March.

This is the result of decisions, actions and omissions. There was a lack of officials and professionals with skills that were up to the situation. There were no training and plans adjusted to the reality of an island that is half of the year under hurricane threat and in seismic zone.

Hiding  information also prevented to stop deaths. Communicating the crisis and the risks in a transparent, credible and effective way protects lives. And it generates public confidence. The document stresses on compassion to recognize and validate citizens concerns 

The study recommends crucial steps, such as identifying high-risk areas and groups, and associated policies. It is also necessary to establish links with the communities. The non-profit sector, already tested in the emergency, is available for these purposes.

In addition, it emphasizes the importance of ensuring effective coordination between local and federal governments, and clearly defining the chain of command. Investigators point out that, in all circumstances, the Department of Health has the responsibility of monitoring mortality. The agency has the power to deal with related situations and must have the necessary supervision tools to intervene early and effectively, publicly and privately.

Most of the recommendations are obvious. A year after the tragedy, many should have been advanced. At the peak of the hurricane season, thousands of families still live in houses without roofs covered with blue tarps. Thousands of people suffer from chronic conditions, and their treatment depends on a still fragile power grid.

Given all of this, Governor Ricardo Rosselló's response falls short when he describes as errors the serious deficiencies that have cost Puerto Rico at least 3,000 lives. More than establishing memorials, it is time to demand accountability and assign responsibilities to officials who were unable to avoid such a painful disaster.

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