ACAPULCO, Mexico — Floodwater still flowed down storm-scoured slopes to the Pacific a week after Hurricane Otis slammed into Acapulco as one of the strongest to ever make landfall in Mexico. Strips of sheet metal lay strewn about the city like giant windblown ribbons. Smells of sewage and putrescence permeated the muddy streets.
But the debris the storm left behind — a fetid melange of everything from hotel night tables to the twisted branches of almond trees — had been piled up to make access easier than the week before.
As the city began to open up to the outside world, one team of disaster physicians rushed to the scene to assess a situation that has been criticized as an insufficient response to the catastrophe on the part of the government.
They were unfortunately too late to avoid the larger disaster to come. As many as 8,500 people will die of stomach and respiratory infections and vector-borne diseases like dengue in the coming months, according to disaster response experts.
“The second wave [of deaths] will be much worse than the first,” said Giorgio Franyuti, CEO of the emergency aid organization Medical Impact, as afternoon mosquitos began to swarm in a neighborhood of unpaved roads where his team set up a mobile clinic on Tuesday. “It’s going to be a massacre.”
In disasters where sanitary infrastructure like water and garbage collection have been incapacitated, there is always a second round of public health threats that often kill more people than the initial event, Franyuti said.
The official death toll of Hurricane Otis stands at 46, with 58 missing, but the broad consensus by those who have seen the extent of the storm’s destruction is that the government's figure is a gross undercount.
People have been forced to gather water from contaminated sources like flood runoff, rivers and puddles, and many are drinking this water and are or will get very sick. Franyuti laments that many will not take his advice to boil the water before drinking it.
Immediate medical attention from civil society groups like his could have significantly diminished the scale of this second wave, but the Mexican military blocked access to Acapulco from the outside world for the first five days after Otis passed.
Mexico's Secretariat of Defense did not respond to questions concerning the purpose of the blockade.
“They’ve already made this situation worse,” Franyuti said. “This can’t be stopped, only mitigated. People are already infected.”
Medics on his team confirmed this. Stomach problems were among the most common complaints they heard at the mobile clinics they set up in working class and rural neighborhoods away from the city’s tourist zones.
They also saw several cases of skin infections, as some of the patients they saw spent 20 hours or more in chest-high flood water, as well as minor injuries and symptoms of anxiety.
Elizabeth Loeza was not in Acapulco when Otis hit. A resident of the state of Nayarit, she came the day after the storm to take care of her mother. She visited the clinic seeking help for headaches, shortness of breath and heart palpitations.
“It’s so good that they came, because people are cut off from the outside world, there are no services, and they’re sick,” said Loeza, 40, as she waited to see a doctor.
Along with Direct Relief, a nonprofit that provides organizations with funds, resources and logistics to respond to disasters, Medical Impact is working to mitigate the effects of this second wave by vaccinating against tetanus, flu, streptococcus, meningitis and others .
But getting these cold chain vaccines, which must be kept between 35.6 and 46.4 degrees Fahrenheit, into an area without electricity and other services is tricky. Medical Impact has a mobile refrigerator for administering these cold chain vaccines, and if they could have gotten into Acapulco sooner, they could have made a significant difference in the second wave.