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Hurricane Fiona Relief

Disaster Relief

Direct Relief staff delivered a power generator to the home of a pediatric hospital patient who requires a 24/7 life-sustaining ventilator and other equipment in Barranquitas, Puerto Rico, on Sept. 20, 2022. (Brea Burkholz/Direct Relief)

Responding to Puerto Rico and the Caribbean

Widespread power outages and rising floodwaters resulted after Hurricane Fiona made landfall in Puerto Rico. Flood impacts were also felt throughout the region.

Since Hurricane Maria made landfall five years ago, Direct Relief has installed backup power systems at health facilities on the island.

Emergency medicines, backup power and mobile health units are being dispatched across the island.

Hurricane Fiona made landfall in Puerto Rico on September 18, 2022, ravaging the southern and central regions of the island just two days before the anniversary of Hurricane Maria. Over 30 inches of rain and historic storm surges caused severe flooding that led to the collapse of roads, bridges, and homes.

Direct Relief’s Ivonne Rodriguez Wiewall inspects Hurricane Fiona damage inside of home in Guayanilla, Puerto Rico, on Oct. 1, 2022. Recovery is ongoing in many communities, where the psychological toll from multiple storms continues. (Photo by Alejandro Granadillo for Direct Relief)

After battering Puerto Rico, Fiona then made landfall in the Dominican Republic near Boca Yuma, with its center reaching the northern coast within hours. The storm caused severe flooding and landslides, destroying homes, forcing widespread evacuations, and leaving hundreds of thousands without power.

The storm brought increased medical demand, in both Puerto Rico and the Dominican Republic, with both locations reporting displacement, injuries and chronic illness-related medical crises, and loss of power disrupted medical equipment and patient care.

Ahead of the storm

Direct Relief responded to Hurricane Fiona by leaning into networks and relationships established during and before Hurricane Maria. Since the 2017 hurricane, Direct Relief established regional disaster response hub in Puerto Rico, and staff members worked with health centers around the territory to assess needs from the storm.

Direct Relief staff in Puerto Rico prepared diabetes medications for delivery to health facilities across the island on Sept. 20, 2022, in the aftermath of Hurricane Fiona. (Brea Burkholz/Direct Relief)

Ahead of the 2022 hurricane season, Direct Relief prepositioned 10 large caches of emergency medical supplies at health clinics across Puerto Rico. Each cache contains 1,680 lbs. of the medical items most needed in the wake of a disaster, including trauma supplies, antibiotics, and medications for diabetes, hypertension, and other chronic conditions.

In addition to the caches of emergency medical goods, Direct Relief had over 100 field medic backpacks full of emergency medical supplies already staged in Puerto Rico. The backpacks were quickly deployed for use by first responders and for delivery to local health facilities caring for people affected by the hurricane. Thirty-six of the backpacks were also shipped to the Pan American Health Organization in the Dominican Republic.

Healthcare facilities that were caring for people affected by the hurricane and its aftermath and needed assistance with medical goods were quickly identified.

In response to Hurricane Fiona, Direct Relief delivered a total of 48 emergency shipments, with a wholesale value of $2 million, to 19 healthcare partners caring for people and communities in hard-hit areas of Puerto Rico and the Dominican Republic.

Aid is distributed in Salinas, Puerto Rico, in Sept. 2022, shortly after Hurricane Fiona. (Photo by Alejandro Granadillo for Direct Relief)

The shipments contained more than 1.5 million defined daily doses (DDDs) of medications including antibiotics, analgesics, insulin and oral anti-diabetes drugs, respiratory agents, cardiovascular medications, water purification tablets, nutritional supplements, and mental health drugs.

In addition, medical devices such as pulse oximeters and glucometers, and consumables such as needles and syringes, first aid products, personal protective equipment, and personal care items were provided.


During the last five years, Direct Relief has facilitated more than 400 projects to strengthen Puerto Rico’s healthcare system through federally qualified health centers and many other local nonprofit organizations.

Direct Relief has furnished 93 health center sites across the island with 170 FDA-compliant pharmaceutical and laboratory refrigerators and freezers with enough capacity to store roughly 6 million vials of vaccines.

Solar panels on the roof of Migrant Health Center in Las Marias, Puerto Rico. The panels were installed to withstand hurricane-force winds, and will provide power back-up when electricity is interrupted. (Erika P. Rodriguez for Direct Relief)

Twenty-five solar-powered water wells have been installed in independent community water supply systems not served by the Puerto Rico Aqueduct and Sewer Authority. Together, these wells provide access to clean drinking water to nearly 14,720 residents in remote areas.

Fire and EMS stations have also been outfitted with solar energy systems, allowing first-line workers to provide essential services during emergencies and power breakdowns. Thanks to these projects, consistent power at these facilities was maintained throughout Fiona.

Read more about Direct Relief’s work in Puerto Rico here.

Health Fairs and Medical Outreach Services

Direct Relief, alongside multiple partner facilities and agencies, organized health fairs for affected communities in the south and western region of Puerto Rico. Mobile units, many of which Direct Relief had funded after Hurricane Maria, served as on-site clinics to provide primary, specialty, and mental healthcare services to hundreds of patients. The mobile units, stocked with Direct Relief-donated goods, were also dispatched to provide medical services to more remote and isolated areas, allowing healthcare workers to deliver uninterrupted care to patients.

Direct Relief staff in Puerto Rico distribute emergency medical supplies and hygiene kits to those impacted by Hurricane Fiona. (Direct Relief photo)

Doctor Laura Domenech, Senior Medical Officer at Ponce Medical School Foundation, reported that Direct Relief provided medications that allowed them to help patients “that lost everything, including medications such as insulin. [Others] didn’t have their prescription refills and could not get doctor’s appointments because they were scheduled for months after the hurricane.”

Looking Ahead

Direct Relief’s emergency response to Hurricane Fiona built on the long-term relationships built over the years since Hurricane Maria. The immediate emergency response efforts, combined with longer-term support through the ongoing provision of medical material aid and cash grants to support healthcare infrastructure and community resilience, played a crucial role in helping the affected communities recover and better prepare for the future.