Puerto Rico’s Death Toll

Héctor M. Pesquera, secretary of Puerto Rico’s Department of Public Safety, has reminded residents of the Island that they can help establish the official death toll for Hurricane Maria in Puerto Rico. Puerto Rico’s death toll was settled at 51 by government reports last month, but there has been controversy over the accuracy of the number.

CNN conducted a survey of 112 funeral homes in Puerto Rico and received reports of 499 hurricane-related deaths. Pesquera, questioned by CNN, said that funeral homes and indeed anyone else with the information should pass it on to the Department of Public Safety.

The Center for Investigative Journalism reported finding 47 more deaths resulting from the hurricane. Other reports have claimed 450 deaths.

Why is the death count so uncertain? There are always problems with getting an accurate death count in the case of a natural disaster.

Problems of definition

Deaths that took place during the hurricane are clearly hurricane-caused deaths. But deaths caused by tainted water, lack of electricity in a hospital ICU, or suicide in a hurricane shelter may not be officially linked to the hurricane.

The Puerto Rico government released figures showing that the number of deaths in September of 2017 was much higher than normal. It seems likely that the additional deaths were at least in part the result of the hurricanes. However, it only seems likely: it is not certain.

There is a continuum from deaths caused by a building which collapsed during the storm to deaths caused by hardships following the hurricane. Deaths from heart conditions, for example, might have taken place without the influence of the hurricane.

Deaths resulting from the lack of electricity in a hospital show up midway along the continuum. Electricity has been a problem for Puerto Rico in the past as well, so a hospital might have been affected by a blackout with some other cause. It is not possible to say with complete certainty that deaths would not have taken place in an ICU without the hurricane’s effects.

Counts vs. sampling

Organizations responding to disasters count fatalities they can immediately see, and use statistical sampling techniques to estimate the total number of deaths. In Puerto Rico, where bridges and roads were out and telecommunication in rural areas is still poor, estimates may have been based on relatively little information.

Pasquines reported that delays in getting officials to remote areas may have resulted in inaccuracies, too. That leads us to another issue.

Official certification

The Bureau of Forensic Sciences must certify any deaths as hurricane-related before they can be included in the official death toll. However, it is reported that 911 cremations have taken place in Puerto Rico since the hurricane without any examination of the bodies.

Once again, logistics issues made it difficult to gather information from remote areas. It is uncertain whether the Bureau had the opportunity to certify all relevant deaths at the time, and it has now been two months since the hurricane. Some people may still be missing, but few would still be available for examination.

It is not unusual for natural disasters to have uncertain death tolls.

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