By Mahlon Meyer
Northwest Asian Weekly
In San Juan, Puerto Rico, Medecins Sans Frontieres (MSF) doctor Jonathan Caldera and MSF nurse Rosa Cifrian walk through La Peninsula to provide home-based medical care for people who lack access to health services. (Photos from Medecins Sans Frontiers)
Amidst the tropical trees and scrub brush, the trailer with its assortment of electronic gear, plastic tubing, and gigantic plastic tubs doesn’t look like much. But when attached to a pickup truck, it can be hauled all over the island and quickly turned into a portable shower unit for up to four people.
The portable shower trailer was designed for the homeless and drug users in Puerto Rico by Wayne Chang, a Boeing engineer —one of many projects undertaken by Doctors Without Borders during the pandemic.
In a departure for the well-known aid organization, also known as Medecins Sans Frontieres (MSF), emergency response teams were sent not only to war-torn African countries—but also to the United States.
“We have been looking at the situation in the United States for many years, and asking ourselves, are we able to respond to these particular needs and would we be an added value compared to other providers,” said Sophie Delaunay, former project manager for Puerto Rico. “MSF realized there were structural gaps in the U.S. system that could be met by our emergency work.”
Puerto Rico was just one of a number of other areas in which MSF moved in to provide assistance. In New York, the organization provided hand-washing stations and other health measures to at-risk populations. In New Mexico and Arizona, it offered health education for Native American populations. In Florida, it provided public health guidance and COVID-19 testing for migrant farm workers. And in Michigan, it trained workers in nursing homes.
But Puerto Rico provides, perhaps, the starkest evidence of the need for such an intervention. Virtually abandoned by the federal government during hurricanes and other disasters, denied statehood, the island has the highest poverty rate in the entire United States and the lowest per-capita income, not to mention widespread corruption, and a massive brain drain as doctors and nurses have fled the island for the mainland, leaving it even more vulnerable during the pandemic.
As a result of corruption, neglect, and impoverishment, parts of the island have running water only every other day—a disaster during the spread of the coronavirus. So when MSF was evaluating where it could have the greatest impact, Puerto Rico was on the list.
It was in this way that Chang, 32, a Taiwanese American Boeing liaison engineer, got involved. It started in April, soon after Boeing had shut down its factories. Chang received an email.
He had worked with MSF before. An autodidact, as a teenager in Mill Creek he had taught himself how to build computers and how to program them. Eventually, working with MSF, he built an aluminum forge from scratch in South Sudan to produce usable aluminum ingots.
When he arrived in Puerto Rico, after quarantining, he and other MSF volunteers worked with local NGOs to assess the greatest needs.
Wayne Chang working with MSF in Puerto Rico
MSF doctors began making house calls to people suffering from chronic conditions, homebound out of fear of going to the hospital or due to sickness. MSF also began distributing hygiene kits to a large population of homeless people and drug users who are housing insecure. And they hired award-winning artists to paint murals showing proper mask use and hygienic measures.
But Chang’s journey was different.
One of the local nonprofits worked with homeless and intravenous drug users.
“This is who we are,” Chang said he told them, in his halting high school Spanish. “What do you need?”
They took him on a ride around the island, where drug users would emerge out of hiding and approach the local nonprofit workers.
“They knew them, they knew them all by name,” he said.
Wayne learned that under normal circumstances, a network of YMCA-type facilities provided showers to those living on the streets. But most of them were closed because the volunteers that staffed them were older and were afraid of contracting COVID.
“We would like showers,” said the local nonprofit.
So Chang’s team first went to Delaunay, who had the final say, to discuss a budget. The cheapest alternative would be to provide a plastic bag of water attached to a tree with a hose running out, they explained. But she authorized more after a group discussion.
Chang and his colleagues scoured the island for parts. They waited outside local Home Depots that would not allow them inside, because of local policy. They ordered from a local Costco. And eventually, they found in the middle of the island a number of gigantic, abandoned oil containers, around 225 gallons each, that they transported back in a giant U-Haul trailer.
“They barely fit,” said Chang.
Wayne Chang working with MSF in Puerto Rico
After scouring the insides with degreasers and cleansers, they were fit to hold water.
And so, using countless other pieces of local equipment, including an electric pump that usually supplies water to a house, Chang constructed a portable shower trailer.
Standing on a rack, under a tent, the shower stall provides room for two people with enough distance for safety. Fans evacuate air to disperse aerosols. And Chang built a backpack sprayer so workers could spray down all the walls with chlorine between each use.
Immediately afterward, he made a video showing how to use it for the local nonprofit that would take over.
Such a move was part of MSF’s traditional practice—training and encouraging local groups to carry on its emergency work. And sometimes local doctors or other aid workers, who are often hired by the organization, are inspired to continue on their own.
In Puerto Rico, after the agency closed its operations last week, a group of four local doctors formed their own nonprofit based on MSF practices.
MSF will close all its operations in the United States this month.
For more information or to donate, go to doctorswithoutborders.org.
To donate to the local nonprofit in Puerto Rico directly, go to: globalgiving.org/donate/44758/intercambios-puerto-rico-inc.
Mahlon can be reached at info@nwasianweekly.com.