After Hurricane Maria struck Puerto Rico, nearly two days passed before Veterans Affairs Emergency Manager Cosme Torres-Sabater had a chance to get outside and assess the damage the country.

“It’s like a nuclear device exploded in the center of Puerto Rico,” the 15-year VA employee said on Friday. “The trees have no leaves. Houses have no roofs. There is floating debris everywhere.”

His normal trip home to the suburbs of San Juan on Friday took more than six hours, weaving along damaged highways and flooded local roads. Luckily, his family and neighborhood were safe.

So too is the San Juan VA Medical Center, which experienced only minor flooding in the cafeteria and a few hallways during the Category 4 storm even though the building sits less than four miles from the island’s northern coast.

While 150-mile-an-hour winds and more than 20 inches of rain pummeled the city, the 300-plus patients and 400-plus employees who rode out the storm inside remained unharmed, if not unaffected.

Now the challenge ahead for the medical center is to return to normal operations on a island that is months away from restoring electricity, phone service and other basic infrastructure needs to all of its residents.

VA officials in the United States have maintained regular contact with local facility officials throughout this storm and the previous one — Hurricane Irma, which passed by Puerto Rico but severely damaged other islands in the region.

The San Juan center is the hub for medical care for more than 93,000 veterans spread throughout the Caribbean. When Hurricane Irma earlier in September forced the closure of outpatient clinics in nearby St. Croix and St. Thomas, 91 patients were transferred to the Puerto Rico site to ensure their health and safety.

Torres-Sabater said that served as a warm up for the Hurricane Maria response. VA officials brought in supplies and prepped staff in advance of the storm, the strongest to hit the island in more than 80 years.

“Even with all of the challenges to our community, our VA employees wanted to report to work,” he said. “They take a lot of pride in supporting our veterans. So they’re happy to be here, and working through challenges in their neighborhoods to get here.”

Mary Kay Rutan, spokeswoman for VA health services covering the Caribbean and Florida, said that enthusiasm has spread to the U.S. mainland as well. As soon as the storm subsided, volunteers from other VA centers began asking what they can do to help. The department is preparing a deployable employee pool to travel to the island in coming days.

“Puerto Rico is a unique challenge for us, because unlike the rest of the country, we can’t just drive in there are deliver supplies once the storm is over,” she said. “So we’re working with our federal partners, making sure we have sufficient fuel and water and food.

“It’s going to take a long time for that community to recover.”

As of Friday morning, VA officials were still assessing when the region’s 10 community care clinics will reopen. That will depend on how much damage those buildings suffered, and whether the surrounding infrastructure can allow travel to the facilities. Benefits offices on the island also remain closed.

Rutan said emergency services at the main medical center have reopened, and officials are providing walk-in care for veterans with mental health needs as well. Torres-Sabater said the hospital is also working with local officials to provide additional medical care to non-veterans in some circumstances.

One of the largest challenges ahead is communication. Since most of the country’s phone networks are down, VA’s telephone switchboards for the region are offline.

Employees in the area with service are being asked to call 1-866-233-0152 to report their status and safety. The VISN 8 TelCare Hotline, 1-877-741-3400, is available around-the-clock to assist veterans with health care advice and information.

Local officials are also using their Facebook page to update patients on the latest developments and connect families on the American mainland with veterans on the island.

Torres-Sabater, an Army Reserve retiree, said he is overwhelmed by the devastation but encouraged by the local and federal response thus far. He said he is proud to be part of the recovery effort, even with the significant challenges ahead.

“This was a catastrophic event,” he said. “But we were able to bring in more employees today and get a break for some of the others. The morale is still high. People want to get to work.”

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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