Personnel from the U.S. Department of Health and Human Services and Department of Defense have begun evacuating dialysis patients from St. Thomas, U.S. Virgin Islands, to San Juan, Puerto Rico, due to the extensive damage to the health care infrastructure on St. Thomas, the HHS said in a news release Sept. 10.

HHS said data from the Centers for Medicare & Medicaid Services indicate that more than 130 American dialysis patients live on St. Thomas. For the first time in the department’s history, HHS medical personnel also have embedded with Urban Search and Rescue teams attempting to find patients who did not respond to local authorities’ message about evacuating. These rescue and evacuation operations are complicated by hurricane damage, which brought down telephone lines and cell towers and has made roads impassable.

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“People who rely on dialysis are among the most medically vulnerable after natural disasters, and given the extent of the destruction on St. Thomas, we are very concerned about the health and safety of dialysis patients there right now,” said HHS Assistant Secretary for Preparedness and Response Robert Kadlec, MD “Our medical personnel and our agency partners are working as quickly as possible under grueling conditions to assist the territory in its life-saving efforts.”

HHS said its emergency managers also are working with territory agencies, dialysis facilities and other partners to arrange dialysis services and temporary shelter in San Juan for the evacuated patients. As patients arrive by plane, health care workers from the local dialysis network triage each patient and provide immediate dialysis or transport of the patient to the hospital if additional care is needed. Partners include Department of Defense, FEMA, CMS, ESRD Network 3, and the Kidney Community Emergency Response (KCER) Program.

Data to support the evacuation came from the HHS emPOWER initiative and CMS systems. To aid in planning, emPOWER provides public health authorities with the total number of Medicare beneficiaries in a zip code who rely on 14 types of life-maintaining and assistive equipment, ranging from oxygen concentrators to electric wheelchairs, as well as data on the number of people who rely on dialysis, oxygen, and home health services. Specific information can be provided for life-saving efforts in a disaster.

Approximately 100 HHS medical personnel are deployed to Puerto Rico and the U.S. Virgin Islands to aid in patient evacuation and to assist U.S. Virgin Islands doctors and nurses in providing medical care in a hospital emergency department in St. Thomas. were staged in Florida with additional teams and Federal Medical Stations on alert to deploy when and where requested.