Nurses taking healthcare door-to-door after Melissa

Weeks after Hurricane Melissa battered the island, the Nurses Association of Jamaica (NAJ) is warning that access to services will be a major challenge for all stakeholders.

Dawn-Marie Richards, senior representative of the NAJ, told THE STAR that a high percentage of healthcare provision facilities were disrupted based on what happened during the disaster. In multiple communities, especially rural pockets of Trelawny, Portland, and St Thomas, damaged clinics, washed-out roads and displaced families have created a cascading impact on routine health needs. Richards recalled visiting the Trelawny Health Department recently, where staff were forced to operate in near darkness. She noted that even when people are physically able to leave their homes, many are deprioritising healthcare while juggling the emotional and financial weight of rebuilding.

"Accessibility becomes a challenge depending on where they live, the state of the facilities, and whether they can even get out of their community," she said.

With some health centres still damaged or partially closed, nurses have reverted to the most basic principle of primary care: taking health services directly into communities, doing 'home visiting'. While not every service can be provided from a doorstep, home visits are now being used for counselling, referrals and urgent checks until facilities regain full function. The social and emotional stress triggered by Melissa is also beginning to show up in concerning ways, with reports of increased tension in households.

"Persons are now more highly stressed, and that can produce ripple effects," Richards said. "Some do not know how to cope with their living situation depending on their partners." She said most nurses are trained in gender-based violence management, and those who do not know exactly who to call for assistance. Mental health teams and behaviour-change officers are also on the ground helping families with psychosocial support.

Richards acknowledged that conversations have already begun about the possibility of a "baby surge" resulting from the storm's stressful aftermath, but she urged caution.

"You don't want to count your eggs before they hatch," she said. "In stressful times, people cope in different ways, and that might be one of the repercussions."

What remains undeniable is that Jamaica's primary health workforce is now stretched thin.

"It is all hands on deck," Richards emphasised. "Our nurses, our behaviour-change teams, our mental health personnel, we all have to go out and do the counselling and support the communities."