Hurricane John struck Mexico's Pacific coast last week, dumping about 80% of the rain local regions typically get over an entire year. The storm, which hit once with Category 3 hurricane-force winds on Monday and then again on Friday with tropical-storm-force winds, is responsible for at least 17 deaths so far. Extensive flooding has been reported in the states of Guerrero, Oaxaca, and Michoacán.

First responders have reported that flooding, mudslides, and other infrastructure-related problems have made it difficult to reach many villages, especially in mountainous areas. In El Espinalillo, an isolated village in the rugged terrain near southern Guerrero's coast, a bridge that connected the southern part of the town with the northern part was destroyed. The village also lost access to services including drinkable water, electricity, and communications, according to Dr. Giorgio Franyuti, Executive Director of Medical Impac t.

The organization sends healthcare providers on medical missions into remote areas, including after disasters. In addition to challenges related to which villages need help due to the electricity and communications services outages, Franyuti said that getting to them has also been delayed due to weather and conditions on the ground.

"After several days of being disconnected from the world, people started to suffer from hunger and diseases from lack of drinkable water, sanitation, lack of food security… this grew into desperation. Some villagers left by swimming to alert authorities they were trapped there. That's how I found out," Franyuti said.

In response to Hurricane John, Direct Relief Mexico has supported Medical Impact with field medic packs, which are designed to meet a variety of medical needs outside of clinic walls A group of medical responders with the organization was able to travel to the impacted area via helicopter to support people with triage needs. Overall, Direct Relief Mexico sent 100 backpacks to the Mexican Secretariat of National Defense Search and Rescue team this year, and supported the health system in the region after Otis made landfall.

"No pilots were daring to make the flight until last Monday. It was a two-hour trip with heavy turbulence. The team was scared but they will not surrender, they were born for this, as heroes and champions climbing out of the aircraft with hundreds of vaccines, medical supplies, medicines, and other supplies to support impacted communities," Franyuti said about the volunteers on his team.

Responders reported many people with open wounds, which they treated. In the days and weeks ahead, however, the threat will shift to diseases.

Vaccines are important, Franyuti said, to combat the pathogen that causes tetanus, which can be easily acquired due to metal debris in floodwaters. He also noted the risk of increased incidences of diarrheal diseases, infectious diseases of the skin, and parasites that are common after events like Hurricane John.

As with the aftermath of Hurricane Otis, Franyuti also expects a spike in dengue fever.

Hurricane Otis, a Category 5 storm, hit the same region last year. It caused at least 50 deaths and billions in damages. Most of the region, including the city of Acapulco, had not recovered from that storm before John, a larger and wetter storm, made landfall.

"This was not like Otis. Otis was razor blades to houses, to infrastructure. This was no razor blade, this was drowning the communities. The threat was different," Franyuti said.

Describing the scenes his team is seeing after John, Franyuti said, "Close your eyes and try to imagine, it's like a knife cut through the jungle and between the mud and mountains of dirt you find small rivers crossing in between cracks that were not there 10 days ago."

Additional field medic packs were sent to Guerrero's Centro Regional de Urgencias Medicas (CRUM), Banco de Alimentos, and BREIM. Direct Relief Mexico continues to assess the situation and is working with local nonprofit partners as well as the federal and state governments to facilitate additional responses related to medicine, medical supplies, and resilient power solutions.

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