I read the menu board and placed my order through the drive-through speaker. In her native Spanish, the employee assisting me rapidly confirmed my order and asked several follow-up questions; I answered “yes” to each question even though I didn’t understand what she was asking me. In the end, the order totaled $9.62. When I opened the contents of the bag, it was like opening a Christmas present, since I had no idea what I had just ordered. And, well, it was Christmastime after all, even though I happened to be in Puerto Rico.
That experience was my first lesson as an American who only speaks English in a place where – although both Spanish and English are official languages – Spanish is the dominant language. Over the years I had wondered why non-English-speaking workers would indicate understanding during training when they didn’t understand. Now I realize it’s a case of assumptions. I thought I knew what the employee at the fast food restaurant was asking, but I was way off. I had never been on that end of the conversation, and now I have a fresh perspective on non-native English speakers and training in the U.S.
I also have a new appreciation for the people of Puerto Rico. While there recently, I was in daily contact with people who’d had no power for 12 weeks. And for some of them, they knew it would be many more weeks before they did have power – and that might be a little optimistic. Not one person was rude or even expressed aggravation at their plight. In contrast, I am aware of utilities that had their front-office glass shot up by angry customers three days after a storm passed.
Even in Puerto Rico’s larger cities, such as San Juan in the northern part of the island and Ponce in the south, where some power has been restored, there are still few working streetlights or traffic signals. Driving outside of San Juan, where there is no working traffic control, has become a mix of jousting and bluff. The practice is to speed up to the intersection and see if anyone slows. If they do, you are in. If they don’t, you wait and surge forward at the next driver. Yet this contrived system of driving is absent the aggression and manic reaction you might expect. No one blows their horn, points a gun at you or even gestures. It’s how you get around, and everyone is simply working it out.
Line crews are figuring it out, too. Some passages through outlying towns have barely 3 to 4 inches on either side of the roadways. In Puerto Rico, you park where you want to shop. Space between the slopes and hills is a rare commodity best used for living, not parking lots. As of the end of December 2017, the Federal Emergency Management Agency’s website stated that 65 percent of the island’s power is back, and 86 percent of potable water systems also are back in service. There are 24,000 blue-tarped roofs on private homes. FEMA also reported that some 14,000 agency, military and civilian personnel are still on the island.
The issue for line crews working in Puerto Rico – materials – is not unexpected. After Texas and the Gulf Coast were struck by storms, many materials went there. When Puerto Rico and the Virgin Islands were leveled, materials already were in short supply. Crews are working with new and recovered materials, but sometimes lack of materials means moving to work locations where materials for the system are available.
Puerto Rico is now home to thousands of lineworkers from the U.S. and Canada, as well as engineers and support staff. Nothing was left untouched by Hurricane Maria, including the island’s hotels. Those that have been brought back online are in the tourist areas far away from the work that still needs to be done. Restoration in Puerto Rico is performed from mobile bunkhouses holding eight men each. Mobile shower and laundry systems have been brought in for crews.
Putting this many people in cramped spaces day after day brings with it a challenge that many safety people are not trained to deal with, especially during flu season. Particularly during this season, camps must take extra steps to minimize the spread of the influenza virus. These steps also are effective for preventing the spread of the common cold and other viruses that are not uncommon in closed, high-occupancy living facilities. The most effective strategy for preventing the spread of viruses in mobile camps is to focus on identifying and eliminating points of multiple touch in public access areas, particularly mess halls.
The first order of business is to provide plenty of handwashing stations that are cleaned daily. The second order of business is to provide a clear explanation of hygiene practices and disease prevention for crews. Otherwise, many of the hidden steps you take will not be as effective in controlling the spread of viruses.
Tables should first be cleaned with detergent. While it’s convenient to use spray bottles for cleaning, it is more effective to use a cleansing solution, buckets and cloth towels to clean tabletops. The cleansing solution should be a mix of water and dish soap, with a half-cup of household bleach per gallon added to that.
After cleaning the tabletop, it should then be disinfected; the disinfectant should remain wet for at least 30 seconds before being wiped with a cloth towel.
The reason for this two-step process is that detergents remove viral contaminants but do not destroy them, so those contaminants simply are transferred to the cleaning towel and later can be spread to other surfaces via the towel. Disinfectants such as Lysol kill viral contaminants but are not effective cleansers. That half-cup of bleach is added to the detergent water to kill contaminants and bacteria brought into the water by the cleaning towel.
Also note that the Centers for Disease Control and Prevention does not recommend bleach solutions as anti-viral agents for decontaminating surfaces. Bleach can be effective in decontamination, but as a surface disinfectant, it is not as reliable as commercial disinfecting products – such as Lysol – are.
Because commercial bottles of popular condiments are difficult to clean and disinfect, providing individual packets of condiments is considered a best practice. However, even piles of packets can easily be contaminated, so managing and using these packets becomes tedious. An alternative is to pour condiments into plastic squeeze bottles. These plastic bottles are designed to be readily wiped and disinfected, as they lack bottle contours, knurled or textured tops, and moisture-harboring labels that cannot easily be disinfected.
Refrigerators and Coolers in Common Areas
During an inspection of the mobile camp’s mess hall, it was observed that cooler handles had not been cleaned of handprints. These touch surfaces should be cleaned and decontaminated in the same manner as tabletops.
The best way to prevent transfer of viral contaminants while serving drinks is to provide those drinks in single-serving, individually sealed units. If drink dispensers are to be used, they should be no-touch dispensers. These are the type that dispense a drink when the user presses a cup against the dispenser’s bar or lever. It also is appropriate to place signage nearby requesting that individuals use a clean cup for each drink they dispense.
Portable Coolers and Ice Kegs
Coolers and kegs should be dumped daily. Before dumping, add a half-cup of bleach per gallon of water in the container. The contents should remain, or be lightly swirled, for 30 seconds to disinfect the interior surfaces of the container.
Cleaning of handwashing facilities should be performed the same way as surface decontamination of tabletops. First, thoroughly clean the facilities with a solution of water, dish soap and bleach, and then wet surfaces for 30 seconds with a disinfectant such as Lysol before wiping them.
The portable lavatory vendor should disinfect the interior of the facilities during pump-outs. Ensure the facilities are pumped and disinfected on a regular schedule. During flu season, it is recommended to perform pump-outs twice a week.
Bedbug Detection and Control
Sleeping quarters must be decontaminated daily, and there should be a system in place to check for rodents and, yes, bedbugs. Anytime you are charged with the health and safety of a large temporary camp, you should consider implementing a bedbug prevention and control strategy. As of press time, bedbugs are not a severe issue in Puerto Rico; however, a few reports in San Juan have been verified, but that is expected since San Juan is a hub for travelers to the island. Bedbugs are not associated with any specific country or social class; they affect the rich and poor alike. As such, there are numerous states with poorly controlled bedbug infestations. There also are major airports reporting bedbugs found in the upholstery of chairs and couches in waiting areas. The reality is there is a likelihood that bedbugs may be introduced into mobile camps, and a little preparation is worth the weeks it takes to rid an area of bedbugs once there is an infestation.
There are insecticides that kill bedbugs, but pretreating is not an effective measure for prevention – early detection and control are. Once bedbugs are established, it will take several treatments, as well as several periods during which all room contents must be isolated, to get rid of them.
Recommendations from the CDC include detection kits that will attract and trap bedbugs early, before they have a chance to multiply and establish colonies. I highly recommend installing at least one detector system in each bunk trailer or housing area that is checked daily by housekeeping staff. If bedbugs are detected, the contents should be removed immediately and sealed, and pest control should be applied. Pest control will kill active bugs, but reapplication every two weeks for one to two months is required to kill hatching eggs if the bugs are allowed to colonize. Quick action is the best practice. That’s because eggs laid will hatch in two weeks, a hatchling takes about five weeks to reach reproduction maturity and female bedbugs can lay one to five eggs a day. Infestation can get out of control in a matter of days if not treated.
If you are facilitating mattresses for a camp, take the extra step to have them bedbug-sealed. These seals protect against bedbugs inhabiting the mattress packing and padding.
A Final Note
One last note about the crews representing us in Puerto Rico: Day after day, as crews from the Fort Allen staging area drove through a small town on the way to their work area, they encountered a little boy in pajamas out on his porch, waving a small American flag. Those crew members – on their own time and with their own money – went into town and bought Christmas presents for the boy, his brother and the rest of his family. They delivered them the day they turned the lights on to his home, December 22, 2017.