For more than forty years, Asociación de Salud Primaria de Puerto Rico (ASPPR), Puerto Rico’s primary care association, has stood as a cornerstone of Puerto Rico’s health care infrastructure, enabling a robust network of community health centers to serve their communities with compassion, innovation, and resilience. Founded in 1984, ASPPR represents the island’s 21 community health centers which together operate nearly 120 sites in 69 municipalities. From its earliest days, ASPPR has played a leading role in the transformation of the island’s health system —expanding access, building health center operational capacity, and advocating for essential policy change,
Puerto Rico has faced extraordinary crises affecting public health and health care —from Hurricane Georges in 1998 to Hurricanes Maria (2017) and Fiona (2022), the Zika epidemic, 2020 earthquakes, and the COVID-19 pandemic— and together with the health centers, ASPPR has adapted in real time. With each emergency, it sharpened its ability to mobilize resources, coordinate emergency response, innovate solutions, and reinforce local clinics as anchor institutions in their communities. Its leadership enabled health centers to maintain essential services even in the face of widespread infrastructure collapse, supply shortages, and communication failures.
Hurricanes Maria – and Fiona
After Hurricane Maria made landfall on September 20, 2017, Puerto Rico’s CHCs became essential first responders and community hubs. ASPPR’s swift action to obtain supplies and equipment, coordinate logistics and secure support helped health centers reopen quickly, often becoming the first operational health facilities in their regions. While the majority of the island was left without electricity, ASPPR worked with the centers to assess needs, obtain emergency fuel supplies and direct technical assistance. ASPPR was on the ground, improvising communication systems using WhatsApp to collect data and connect health centers with local service and government colleagues, HRSA, NACHC and other partners. Recognizing an opportunity to build resilience across the community health center network, ASPPR established partnerships with public and private organizations to support the installation of solar power infrastructure. This onsite power system could be maintained during future outages to protect vital healthcare infrastructure in response to escalating climate hazards.
These resilient energy systems proved crucial when Hurricane Fiona hit, five years later. The solar power system installations allowed health centers to maintain operations as the tropical cyclone pummeled the island. Radio communication networking established after Hurricane Maria also became invaluable to triaging information, routing and managing supplies, and managing services. These experiences proved important to withstanding new challenges and crises that followed. During the 2020 earthquakes and the COVID-19 pandemic which came nearly on its heels, the communication strategies and relationships with local community organizations and national partners ensured that Puerto Rico’s health centers had access to the material support and guidance needed to serve their patients and communities.
Moving Beyond Disaster
While honing expertise in responding to humanitarian crises, ASPPR has continued to provide training, technical assistance and subject matter expertise to support health center services. ASPPR’s investment in technology, support for data analytics, and its policy advocacy on behalf of its member health centers reflect a long-term commitment to building and sustaining a high-quality health center network that is prepared, accessible, adaptive, and rooted in community trust.
As Puerto Rico continues to confront climate instability and threats to public health infrastructure, ASPPR remains a leading advocate for essential primary care for more than 465,000 people who depend on the island’s community health centers.
