As 20-foot storm surges and 220-mile-per-hour winds slammed the coastline, people sheltered away from windows and sought news on portable radios. Those fortunate enough to have evacuated waited for word from family and friends, and those remaining at home anxiously hoped the storm would soon pass.

It was September 2, 2019. Hurricane Dorian was making landfall in the Bahamas, an island nation less than 200 miles off the east coast of Florida. One of the most catastrophic Atlantic hurricanes in recorded history, Dorian left over 70,000 people, more than one-sixth of the population, in need of aid. The hurricane was also one of the first major storms climatologists link directly to climate change.

Dr. Kathleen Sullivan Sealey, Climatologist and Professor of Biology at the University of Miami, said that severe weather and climate change are inextricably linked. “The climate is being altered by humans,” Dr. Sealey told Direct Relief. “The challenge is educating people about climate change and what are going to be the realities after a disaster.”

Climate change will continue to cause severe storms and extreme weather events worldwide. In the Bahamas and elsewhere, Direct Relief is working to secure health infrastructure and prepare for the future. Last week, Tropical Storm Nicole passed through the Bahamas, and though there was no major damage, the storm surge flooded roads and temporary power outages occurred on several islands, including Abaco and Grand Bahama. All of the Direct Relief-funded projects installed after Dorian remained unaffected by the recent storm.

After Dorian, chaos unfolded in the storm’s aftermath, as disaster workers focused on search and rescue and providing access to clean water. Lacking power and facing devastated infrastructure, hospitals struggled to return to normal operations.

With major airports damaged, it was difficult to move critically ill patients to locales where they could receive care.
In addition, finding family and friends proved complicated. “Communications were down in the weeks after the storm, the cell tower infrastructure was completely wiped out. Locating individuals literally came down to physically showing up to their last known locations for proof of life,” said Robert Sweeting, a Direct Relief Program Specialist based in the Bahamas.

As the storm passed, Direct Relief mobilized medical aid shipments to support emergency medical teams working in isolated areas. These shipments also supported clinics and hospitals treating both evacuees and those who sheltered in place. After deploying over 240 tons of medical aid to shelters, hospitals, and clinics providing emergency care following the storm, Direct Relief committed resources to ongoing recovery efforts in The Bahamas.

Recovery is extremely important in the wake of climate events like Dorian. “Professional disaster relief personnel know the shock, but we’re not doing enough to educate people. How do you survive not only the storm but the recovery?” asked Dr. Sealey. She has been central to ongoing efforts in both the Bahamas and Florida to prepare more resilient strategies for future disasters.

Key in these strategies is power: individual homes as well as small businesses and government facilities need sustainable power supplies. During Dorian, when gas generators were sent out as part of relief efforts, gas rationing ensued, creating more difficulties. Today, lithium batteries are scarce and fuel prices are spiking. Sweeting described how “power outages are a normal part of daily life here [in The Bahamas] and the cost of power is among the highest in the world.” Averaging around $0.44 p/kW hour, prices continue to increase as a result of the current economic climate.

Power and health are strongly linked, particularly after disasters. This played out in Puerto Rico after Hurricane Maria, when power was out for an extended amount of time, leading to thousands of deaths due to interrupted health care.

Solarization sidesteps these problems. “Outside of the environmental benefits of solar, it is more cost-effective and reliable versus the traditional power grid in The Bahamas,” Sweeting said. While individual solar panels may not power a whole home, they run the essentials: refrigerators, fans, and routers, as well as medical equipment like ventilators, pumps, and lifts.

Though Dorian’s strength—and the magnitude of the storm’s ensuing destruction—were unprecedented, Bahamians already had strategies leading up to and after the storm. Before landfall, people living in the Bahamas moved cars to higher ground. In the longer term, people are beginning to concentrate on small-scale agriculture as the cost of food rises. Since 9/11, when food supplies to the Bahamas were disrupted for over a month, and in the wake of Covid-19 supply chain turmoil, residents have also looked to stockpile food staples. Some are turning to traditional preservation methods like pickling and canning. Others are installing rain tanks as wells go dry due to the ongoing effects of climate change.

Further, “Bahamians, in general, are becoming less dependent on electricity,” Sweeting said. “Most residents now minimize the use of big power drainers such as air conditioning, cooling their homes with fans and open windows instead to reduce costs.” People are choosing solutions that lower their carbon footprints.

Additional innovative storm-preparation solutions include local government steps to increase accountability amongst the population. Putting notifications in writing and setting out storm-preparedness protocols and facts about communicable diseases increases access to information that may not have been widely distributed before.

Rebuilding and erecting new facilities is also an indispensable part of recovery efforts. Direct Relief has funded extensive projects to reestablish the Bahamian healthcare network, including a new clinic on Grand Bahama Island that can sustain winds up to 220 mph. The organization has helped rebuild and restore four other clinics and health care centers, and mobile units now reach remote residents. Soon, construction will begin on a new clinic in Great Guana Cay.

These facilities provide services for residents, and some furnish housing for medical staff. In partnership with the Ministry of Health, Direct Relief designed two centers, currently in the process of being built, that will be self-sustaining and solar-powered.

In Abaco, several clinics will have rooftop solar panels that feed back into the grid. These will be the only healthcare facilities in the region to utilize solar power as backup, an integral part of maintaining electronic medical records and properly storing refrigerated supplies during power outages.

Direct Relief’s support has been integral to getting health infrastructure up and running again. In addition to crucial on-the-ground support, Direct Relief’s work in the Bahamas is providing invaluable information on how low-lying countries in the Caribbean and elsewhere work to recover after storms. Yet on Abaco, Grand Bahama, and other islands, rebuilding is still taking place.

As perhaps the “largest donor/partner to public healthcare in the Bahamas after Hurricane Dorian, our support directly led to the reopening of the two major healthcare centers in the Northern Bahamas,” Sweeting said. Direct Relief’s partnership also allowed these centers to expand their footprint to offer services in places that were previously underserved.

Storm-affected areas have major ongoing needs such as housing and communications infrastructure. The Bahamas continues to face public health challenges exacerbated by these needs, but monitoring the evolving situation can be a learning process that helps island nations prepare for the effects of climate change and illuminates future disaster response efforts.

Heath Pennington (they/them/theirs) is a communications fellow for Direct Relief in partnership with the UCSB Interdisciplinary Humanities Center’s Public Humanities Graduate Fellows Program.