The intensive care unit of the hospital ship USNS Comfort began taking on critical patients Wednesday night in a series of air medevacs from overwhelmed hospitals in Puerto Rico, U.S. Northern Command said Thursday.
The Defense Department also said the Mercy-class Military Sealift Command hospital ship is being shifted from its mooring in San Juan on the island's northern coast to Ponce on the southern coast, where the medical crisis is more acute in the aftermath of Hurricane Maria.
In one operation, Army UH-60 Black Hawk helicopters picked up five critical patients at Ryder Memorial Hospital in Humacao on the island's southeast coast and flew them about 36 miles to San Juan, NorthCom said in a statement.
They were transferred on MH-60S Seahawks by the Navy's Helicopter Sea Squadron (HSC) 22 "Sea Knights" to the Comfort, which has 200 hospital beds and more than 500 medical personnel aboard.
"Working with the Army and the hospital, we were able to reduce transport times for critically ill patients," said Lt. Cmdr. Christopher Perry, a dual-designated emergency physician and naval aviator aboard Comfort who flew one of the Black Hawks.
"This is the mission we have all been training for," he was quoted as saying in the NorthCom statement.
More than anything else, what the Comfort has that many of the hospitals on the island lack is air conditioning. Hospital officials in Puerto Rico have reported that temperatures on some wards have reached 108 degrees Fahrenheit.
Patients have also had difficulty in reaching hospitals due to washed-out bridges and roads made impassable by hurricane debris and downed power lines.
All of Puerto Rico's 69 hospitals were knocked off the grid as the entire island lost electricity when Hurricane Maria hit Sept. 20 with sustained winds of more than 150 mph.
The hospitals have been struggling to run on generators, but those have been breaking down and fuel deliveries have been inconsistent.
"The possibility of hospitals in Puerto Rico failing due to running on emergency generators for extended lengths of time had been planned for by Comfort, the Federal Emergency Management Agency, and other federal and local agencies," NorthCom said.
At the Pavia Arecibo Hospital about an hour west of San Juan, administrator Jose Luis Rodriguez said, "We don't have any air conditioning. We can handle maybe a week, but it's already been two weeks" since the hurricane hit, National Public Radio reported.
"We have hospitals that are working, but eventually we are going to have to transfer patients," Carlos Méndez, an associate administrator at the Auxilio Mutuo Hospital in the Hato Rey district of San Juan, told USA Today. Mendez said the island's health system "right now is on life support."
Army Lt. Gen. Jeffrey Buchanan, commander of U.S. Army North, told The Washington Post that the military will begin setting up field hospitals to ease the crisis.
He said the Army will put two field hospitals in the Humacao area and the Air Force will set up one in Aguadilla, on the island's northwestern tip.
Buchanan arrived in Puerto Rico last Friday to take charge of the military response as the mission shifted from a sea-based to a land-based operation.
As of Thursday, the Defense Department said about eight percent of the 3.4 million U.S. citizens in Puerto Rico have electricity and about 47 percent have access to safe drinking water.
The DoD also said water-tanker trucks are reaching all 78 of Puerto Rico's municipalities.
The Comfort moored in San Juan on Tuesday during President Donald Trump's four-hour visit to the island, in which he gave high marks to the relief effort and casually flipped paper towels and other items to a crowd at a San Juan church.
"I think it's now acknowledged what a great job we've done, and people are looking at that," he said in San Juan.
Trump's remarks and behavior during the visit rekindled a feud with San Juan Mayor Carmen Yulin Cruz, who has criticized the scope and pace of recovery operations.
Yulin Cruz called the president's visit a public relations stunt and charged that he failed to consult with the island's mayors.
"And in fact, this terrible and abominable view of him throwing paper towels and throwing provisions at people -- it does not embody the spirit of the American nation," she said on MSNBC. "He was insulting to the people of Puerto Rico."
During his visit, Trump questioned Gov. Ricardo Rossello about the death toll in Puerto Rico from Hurricane Maria. Rossello gave him the figure of 16, and Trump said Puerto Rico should be "proud" of the low number from such a devastating storm.
Island officials had been using the count of 16 for more than a week while warning they were unable to reach morgues and hospitals to get a more accurate assessment because of poor communications.
On Wednesday, Rossello said the certified death toll had more than doubled to 34 and he expects the count to rise.
He said 19 of the deaths were directly attributable to the hurricane and 15 others occurred in the aftermath, some for lack of medical care.
