As the death toll rises in the wake of Hurricane Irma, so does concern for the physical and mental wellbeing of vulnerable populations across the territory, including senior citizens.

Government officials have said that four individuals died as a direct result of Irma on Sept. 6, with police confirming the identity of the last victim, St. John captain Richard Benson, just last week.

But exact figures for the total number of people who have died since the storm have not been provided.

Vincent Wheatley, chairman of Virgin Gorda’s recovery committee, estimated last week that six people had died on the sister island since Irma. No estimates have been disclosed for other islands or Virgin Islanders living abroad, but post-storm deaths include a handful of prominent community members.

At least four of them were senior citizens: former ZBVI Radio founder Merrit Herbert, longtime educator Inez Turnbull, pilot and businessman Neville Brathwaite Sr., and Lilian Romney, the widow of former Chief Minister Cyril Romney.

Dr. Virginia Rubaine, director of community mental health at the BVI Health Services Authority, said catastrophic events often have serious effects on the elderly population. Though Dr. Rubaine added that without further data she could not connect specific deaths with the hurricane, she said that some “seem to be Irma-related.”

“It’s shocking; the people who have passed since Irma were people that everyone in the community knows,” she said. “Through my experience being trained in natural disasters, you typically see an uptick in seniors dying in the aftermath.”

Mental wellbeing

For elderly residents across the territory, Irma upended any sense of normalcy and altered daily routines.

Many older people, Dr. Rubaine said, have had to come to grips with the fact that the next few years may not look the way they had planned.

“They expect to live a life of ease after working for years, and instead they are experiencing a lack of resources,” she said. “They have to depend on relatives and friends; their children may have moved away. There’s a sense of helplessness.”

That new reality can impact mental health, Dr. Rubaine said.

“Elders in this situation are prone to depression,” she explained. “I see this with seniors in my own village. One man in my village even said to me, ‘I never thought in the end of my life I would be in this predicament.’ They didn’t prepare for a catastrophe of this size, so they could have feelings of confusion, of hopelessness; those are all signs of depression.”

Medication

Natural disasters can also impact access to necessary medications for those with chronic diseases, such as diabetes and hypertension.

Thousands of residents were forced to flee their homes during Irma — either during the eye or after the storm was over — potentially leaving behind medications in their hurry to find shelter.

Others expressed concern that in the days following the hurricane they couldn’t properly keep insulin refrigerated, or ran out of certain prescriptions.

Beyond merely having a steady supply of medication (and essential diet foods), senior citizens may face new obstacles to taking that medication on a regular basis.

A study conducted after Hurricane Katrina, published by the American Journal of Medical Sciences, found that almost half of the patients polled did not take their antihypertensive medication perfectly on schedule in the year after the storm — some unintentionally, others intentionally.

“In post-disaster situations, when the health care infrastructure is in disarray and personal and financial losses escalate, additional barriers to medication adherence may exist, further compromising blood pressure control and health,” the study concluded.

Chronic diseases

Dr. Rubaine said some of those barriers also apply to residents living in the territory post-Irma.

“Chronic diseases like diabetes and hypertension have always been a cause for grave concern in our population,” she said. “There are a myriad of issues that could arise out of our new normal, our new circumstances, that could exacerbate those pre-existing conditions.”

One such issue is getting prescriptions filled for those in more remote areas. While the Peebles Hospital pharmacy and a few others are up and running, Dr. Rubaine said some, like the one in Cappoons Bay, were heavily damaged.

Residents who relied on that pharmacy will now have to travel to Road Town or make other arrangements.

To assist with such challenges, several doctors with the BVI Health Services Authority are going out to parts of the community themselves to provide primary health care services.

“Our primary care providers are alleviating that stress a little bit,” Dr. Rubaine said.

Taking care

Without further information it’s difficult to tell how the death rate since Irma stacks up to an average six-week period.

According to the most recent information from the Central Statistics Office, there were 136 deaths in the territory in 2015 (34 of whom were 85 or older) — in other words, roughly 11 people a month, spread between the various islands.

Since Irma, Davis Funeral Home confirmed that it has handled six deaths, but Scatliffe Funeral Home could not be reached for comment.

Police Information Officer Diane Drayton said she did not have information about the total number of deaths. The Central Statistics Office and the Coroner’s Office did not immediately respond to information requests.

Dr. Rubaine urged the community to look out for those around them who might be struggling.

“We can all check up on the most vulnerable in our community,” she said. “We might assume someone else is doing it, or get busy with our own problems — even now I’m thinking about the water in my house — but some seniors may not have access to town, may have lost cars.

“It’s a matter of asking, ‘Have you eaten today?’ or checking up on their medication, or going to the pharmacy. You don’t have to wait on government; we can take it upon ourselves.”

 

This article originally appeared in the Oct. 19, 2017 print edition.