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Editor’s Note: This letter was originally written to Oscar Arce, owner of a Fort Lauderdale-based aviation company whose support helped make the medical mission possible. Dr. Jesús Cruz, a physician and director of Hospital San Lucas, also assisted with the response. In the letter, PA Ferrera Ramos reflects on traveling to Puerto Rico after Hurricane María to provide medical care in shelters throughout Ponce. The author’s original voice and the letter’s informal, personal style have been intentionally preserved.
Service & Legacy: A Letter
Dear Mr. Arce,
I wanted to thank you soon after I arrived home, September 2017, after Hurricane Maria, but I only found your card today. I was granted access to a flight from Fort Lauderdale to Puerto Rico on one of your Learjets. The flight brought me to PR to volunteer as a Physician Assistant to provide medical care in Ponce after the hurricane. I decided to go on the medical mission because my husband’s relatives and others needed help after the devastation and deaths of almost 3,000 Puerto Ricans.
Jose’s Hands was the group that arranged for us from the States to help after the disruption of many lives on the Island. I knew your company had flights to P.R., so I flew from New York’s La Guardia airport to Fort Lauderdale. I got a taxi to your airstrip and waited many hours until a pilot came through the waiting area and asked, “Does anyone need a ride to Puerto Rico? My flight will deliver water and portable generators, and has seats available.” After many hours of waiting, I said a very quick “Yes” to the offer. Another P. A. and a nurse also said “Yes, please!”
I introduced myself to the P. A. from California and the RN from North Carolina. They were also volunteers for the medical mission. We had a safe trip on a beautiful plane and got to know each other’s backgrounds. I said, “I have relatives in Ponce with whom I lost touch via e-mail and phone, because of the sketchy wi-fi networks. My letters weren’t answered.” I went on, “I feel a responsibility to help the people at a time when there are so few medical providers available.”
Unfortunately, when we landed, our contact was unavailable via phone. We got a lift to the Public Health central headquarters near the hotel. The PH folks said, “Go to Ponce where there was a need to see patients in shelters.” The woman was with a private non-profit corporation. She suggested we stay in the Children’s Hospital in Guaynabo overnight, which had accommodations. The health-care foundation lady said she would drive us to Ponce the following morning. We got something to eat at the hotel. Then we were driven to Guaynabo to bunks in the pediatric hospital. The following morning we were picked up by a woman from the health-care corporation who graciously drove us to the San Lucas Hospital in Ponce.
She said that Dr. Jesus Cruz, the Hospital Director of San Lucas Hospital, told her he would be pleased to have us volunteer at the shelters. He oversaw 10 or so shelter clinics that were set up in schools surrounding Ponce.
As we drove across the island, the devastation to homes in many of the areas was stunning. There were no roofs on some houses, others were totally obliterated, and still others were unscathed. Most of the palm tree tops were gone, as we got further from Guaynabo. The people we saw along the way were seen standing in line in front of banks. We were told they could only withdraw $ 50 at a time each day. There were only cash dealings since there was no internet. Some of the pharmacies were open, but there were few lights on and, of course, no transactions other than with cash, we were told.
At the San Lucas Hospital, we were greeted by Dr. Jesus Cruz, the Hospital Director, who said, “I can’t show you around the hospital since I’m needed at several places at once,” even as he said hello. A nurse showed us to our rooms where extra hospital staff usually stayed. We were given sheets and a pillow, but no blankets. We noticed immediately that it was very, very cold in the rooms. The AC system was set very low and couldn’t be changed since the hospital worker who dealt with temperature was pulled to work on the main power grid. To stay warm at night, I walked over to the pharmacy across the street and bought leggings.
Dr. Cruz caught up to us in the staff cafeteria, where we were given breakfast. He asked> Would you help set up an external pharmacy outside of the hospital’s pharmacy this morning?” We said, “Of course.” After we established an alphabetical system for the donated medications, he had us accompany him to several of the clinics around the hospital. After we were dropped off, he said, “Please get information from the shelter occupants about their diagnoses and medications, and ascertain whether they had prescriptions for ongoing medications. If they need prescriptions, please submit the requests to me for authorization.”
As an aside, Dr. Cruz asked where I was from. I said, “I was born in Manhattan and raised in the Bronx on Wales Avenue and 143rd Street, near St. Mary’s Park in Mott Haven.” He said, “It’s a small world. I did my residency in obstetrics and gynecology at Lincoln Hospital on 141st Street, right near St. Mary’s Park.”
The patients were very happy to see us. One woman was a retired social worker who worked in the Bronx. She said, “My house was completely flattened. I don’t know how I got out alive, only because my neighbor banged on my door. Thank you so much for coming from New York to help us.” In all, we evaluated patients in 10 shelters. We evaluated those who needed extra care or hospitalization and notified Dr. Cruz.
When I had an afternoon off, I walked over to the wonderful Ponce Museum of Art with its many works of European and Puerto Rican art. The museum was beautifully designed by Edward Durell Stone. Luckily, I happened on the Muñoz Rivera square, with a statue of the former governor, distantly related to me by marriage. He was my mother-in-law’s cousin, Ana Maria Rivera Ramos. Afterwards, I was able to find that the famous Gold’s ice-cream store was open near the historic Ponce fire station building, and got an ice cream cone. “We acquired a generator and are back in business momentarily”, they said at Gold’s.
We were pleased that we contributed to the patients’ well-being. We stayed for 10 days and were thanked profusely by Dr. Jesus Cruz for our presence. We got a ride back to a church in San Juan to stay overnight that had 100 beds on its ground floor. There were no showers, but the cots were comfortable enough, and the bathrooms were clean. The next day, we got a ride back to the private airport. Luckily, we got a plane trip back to Fort Lauderdale. I think it was also one of your airplanes.
“Thank you for making it possible for us to be in Puerto Rico after the hurricane to care for Ponce’s patients.”
Yours truly,
Maryann Ferrara Ramos, MPH, PA-C Emeritus
Medical Reserve Volunteer, Greenwich, CT
Closing Remarks:
PA Ferrera Ramos’s story is a powerful reminder that service, leadership, and collaboration can leave a lasting impact on the communities we serve. We are honored to share her reflection and recognize the legacy she continues to build within the PA profession. 🌟
🇵🇷 Resumen en Español
Nota de los editores
Esta carta fue dirigida originalmente a Oscar Arce, director ejecutivo de una compañía de aviación privada con sede en Fort Lauderdale, cuyo apoyo aéreo facilitó el traslado de voluntarios y suministros a Puerto Rico. José’s Hands coordinó la participación de profesionales de la salud provenientes de Estados Unidos, mientras que el Dr. Jesús Cruz, médico y director del Hospital San Lucas en Ponce, supervisó las clínicas establecidas en los refugios.
Resumen en español
Tras el paso del huracán María en 2017, PA Ferrera Ramos viajó desde Nueva York hasta Puerto Rico para ofrecer atención médica voluntaria en Ponce. Desde Fort Lauderdale, logró abordar uno de los aviones de la compañía de Oscar Arce que transportaba agua y generadores a la isla. Junto con otra PA y una enfermera, colaboró con el Hospital San Lucas y el Dr. Jesús Cruz en aproximadamente diez clínicas establecidas en refugios escolares.
Durante diez días, el equipo evaluó a pacientes, identificó necesidades de medicamentos y recetas, organizó donaciones farmacéuticas y coordinó atención adicional u hospitalaria cuando fue necesario. En su carta, PA Ferrera Ramos recuerda la devastación que presenció, la gratitud de los pacientes y la colaboración que hizo posible la misión. También expresa su agradecimiento a Oscar Arce por facilitar su llegada a Puerto Rico y permitirle servir a las comunidades de Ponce en un momento de profunda necesidad.