Maida Derouiche, 57, was at her daughter’s house in Ponce, Puerto Rico, when a 6.4 magnitude earthquake hit Jan. 7, 2020.
“It was not easy,” Derouiche said. “It was a moment of many mixed emotions because at my age, I had never gone through that kind of situation, with a granddaughter by my side.”
Her daughter was there, too. Together, they prayed and tried to keep calm until the tremors passed. Afterward, they went outside to support their neighbors.
Even though the most severe earthquakes have subsided, Derouiche and her family feel stressed even during minor quakes.
“From now on we do not forget this,” she said. “We still get emotional when it shakes a little bit, because it has happened.”
The 2020 earthquakes brought additional damage, death and stress to an area still recovering from Hurricane Maria, which hit the island in 2017.
The storm destroyed the commonwealth’s outdated electric grid, and it was 11 months before full power was restored.
Maria also caused more than $90 billion in damage, making it the third most costly hurricane in U.S. history, and ranked among the deadliest, with an estimated 2,975 deaths in Puerto Rico alone, according to a George Washington University report.
Both disasters occurred amid the backdrop of limited economic opportunities, a declining population and widespread frustration at local political leaders.
To help Puerto Ricans cope, the Florida United Methodist Foundation gave a $50,000 grant to Rebuilding Communities with Hope (REHACE), a nonprofit community outreach ministry of The Methodist Church of Puerto Rico.
The money funded a program called RED — Resiliencia Emocional ante un Desastre or Emotional Resilience to a Disaster — which provided case management, individual and group therapies, and community workshops to foster recovery and wellness for natural disaster survivors. The goal was to help them become emotionally resilient so they could better cope with future disasters.
“It was not easy. It was a moment of many mixed emotions because at my age, I had never gone through that kind of situation, with a granddaughter by my side.” — Maida Derouiche, RED participant
RED also received financial support from the Community Foundation of Puerto Rico.
Dr. Glorymar Rivera Báez, executive director at REHACE, recognizes the need to help Puerto Ricans deal with the emotional stressors disasters cause.
“Emotional crises are serious issues that we must address with the formality and responsibility it deserves,” Rivera said.
Countering the stigma around mental health
Despite the great need for mental health support, many in the commonwealth hesitated to reach out.
It’s something Dr. Vivian Álvarez Torres, who worked as REHACE’s supervisor of psychological services, saw repeatedly in the outreach process.
“People in Puerto Rico, they need emotional support, but they are so scared to say, ‘Hey, I need emotional support,’ so they prefer to reject the service,” Álvarez said. “That’s why it has been so challenging to connect with those people. That’s why we use the church and organization to try to provide this service.”
REHACE reached out to survivors through The Methodist Church of Puerto Rico and by networking with other organizations and residents. Soon, people were seeking help by word-of-mouth. RED led its first session Dec. 14, 2020, and the program ran through June of this year.
Interested participants first went through a clinical screening that measured symptoms of depression, anxiety and quality of life to assess which services would best meet their needs.
They then gathered in groups of no more than 10 for in-person sessions led by two clinical psychologists in the cities of Ponce, Guayanilla, Yauco and Peñuelas.
Each group participated in five sessions. While open to anyone 18 or older and of any religious background, sessions considered the spiritual needs of the group and began and ended with a prayer or meditation.
By the end of the fifth session, Álvarez said many participants saw the benefits of therapy and wanted to continue. Participants received referrals to one-on-one care with professionals that accept public or private insurance plans.
It’s all part of the process of normalizing mental health care in Puerto Rico.
“I think that is our responsibility as clinicians,” Álvarez said. “Because for years we were talking about mental health in a negative way instead of talking about mental health as physical health.”
A solution to emotional distress
Wilfredo Martinez Cubano, 62, heard about RED from his pastor at The Methodist Church of Aguas Buenas.
He initially dismissed going to the sessions because he thought they were designed to support people who were more affected by earthquakes than he was. He lived in the interior of the Island, further from the fault line, and felt the impact there was less severe. But after his pastor urged members of the church to go, Martinez decided to attend.
While he came through the earthquakes relatively unscathed — beyond some shaking felt during the hardest quakes and some cracks in his house — Martinez says Hurricane Maria disrupted his life.
Like his neighbors, he had to stand in long lines to buy things he needed, including essentials, causing him to go without. And because he lives in the mountains above Caguas, near the town of Aguas Buenas, other tasks were a challenge.
“It was a lot to get cash. You have to go to a bank in the metro area. You had to go to a certain area to be able to use the cell phone — there wasn’t any coverage,” Martinez said. “It was pretty bad.”
In the immediate aftermath, Martinez says he experienced sadness and confusion, but also positive moments. The disaster united his community.
“In this area, I didn’t know anybody. And all of a sudden, we’re meeting, we’re eating together, we’re sharing things,” Martinez said. “So that was the best part of the process.”
He says he often picked up supplies from his church and shared them with neighbors.
And while he admits to being nervous about the RED group sessions, he was also curious — it was his first experience with mental health therapy. He wondered what he’d be asked to share with the group and if he’d feel uncomfortable doing so.
“Emotional crises are serious issues that we must address with the formality and responsibility it deserves.” — Dr. Glorymar Rivera Báez, REHACE executive director
“But it was totally different from that,” Martinez said. “We got together. Everybody would talk (about) the different fears, the different problems, and it was a great therapy.”
Puerto Ricans have experienced one crisis after another, so dealing with the emotional and spiritual harm disasters cause is a priority. Martinez says the RED program is a solution.
“One thing that I tell the people and I tell my family, everything in life has a solution,” Martinez said. “You can’t say, ‘No, I can’t do this. I can’t do that.’ … You just have to pursue it and get and reach your goal.”
Even though the immediate challenges of recent disasters have been alleviated, the community is still rebuilding.
“Everybody’s still trying,” Martinez said. “That’s what I believe, because there are some places that still have, you know, these blue covers on their roofs. … People need that help that REHACE has been providing.”