Even as communication remains limited to Puerto Rico in Hurricane Maria’s aftermath, the first wave of medical shipments are leaving Direct Relief’s warehouse, bound for the island, where the need for essential medicines is high.

Staff are in contact with the Puerto Rico Department of Health, Emergency Operations Center and the Puerto Rico Primary Care Association, a network of federally qualified health centers.

In addition to immediate needs like potable water and diesel, Department of Health officials have also said medicine is a critical need and are evaluating the ability to accept vaccines and insulin, which must be kept cold.

A shipment of essential medicines will arrive today in Puerto Rico, packed with medical supplies like wound care, antibiotics and other medical supplies specifically requested by the Puerto Rico Department of Health.

Emergency Health Kits left Direct Relief’s warehouse on Monday and will arrive in Puerto Rico on Wednesday.  Six hundred hygiene kits, and 12 medical backpacks, which equip first responders with medical supplies, will arrive in the coming days.

Direct Relief staff will be in San Juan, Puerto Rico, by Wednesday, and will be bringing critical medicines, like requested antibiotics and inhalers.

Meanwhile, power outages continue to leave millions of residents in the dark. The lack of power also means that many hospitals are running on generators, but that fuel is limited and medicines are also in short supply. Cell phone reception has been extremely limited, with about 95 percent of wireless cell sites out of service

On the northwest corner of the island, portions of the Guajataca Dam have fallen and the government is working to assess the rest of the dam and whether it will collapse.

“It represents a great danger for about an estimated 70,000 people,” according to Puerto Rico Governor Ricardo Rossello.