Maya Angelou once penned words that thunder across generations: a defiant proclamation that no matter how deeply we are pressed into the earth, no matter the weight of history or circumstance bearing down upon us, the human spirit possesses an unyielding determination to rise. This speaks to the lived reality of survival against impossible odds; odds that faced Jamaica when Hurricane Melissa made landfall on its southern coast with sustained winds exceeding 160 miles per hour. Beyond testing the infrastructure of this resilient island-nation, it exposed the precise fault lines where 21st-century climate realities collide with 20th-century systems, revealing truths about vulnerability, resilience, and the future of healthcare that the world can no longer afford to ignore.
A Storm Beyond Our Designs
When Category 5 Melissa finally made landfall after circling Jamaica like a predator studying its prey, foreshadowing gave way to fury. For hours, it hammered the island with unprecedented intensity; a violence that bore little resemblance to the hurricanes encoded in institutional memory or engineering manuals. Power grids collapsed within hours, plunging entire parishes into darkness, and communication towers toppled like dominoes, severing the digital lifelines that connect us to help, to information, and to each another.
Western Jamaica bore the brunt of Melissa’s wrath, and parishes like St. Elizabeth, Westmoreland and St. James faced devastation so complete that responders – yet, survivors – struggled to find words adequate to the scene. Entire neighborhoods were stripped to their skeletal frames, belongings scattered across mud-choked streets, family photographs drowning in debris. Children’s toys hung from power lines. Refrigerators lay overturned in roads. The markers of ordinary life, kitchen tables, wedding albums, medication bottles, became rubble. And amongst that rubble were, soon to be found, human beings who drew breath only hours before.
Jamaica would emerge from this maelstrom to find roofs torn from 80–90% of homes in affected regions, revealing how our modern infrastructure functions like a house of cards when nature decides to blow.
When Hospitals Become Casualties
Five hospitals across the island sustained significant damage, their infrastructural vulnerabilities reflective of decades of difficult choices—investments deferred, maintenance postponed, upgrades delayed in favor of more pressing demands. Like many emerging economies, Jamaica’s healthcare infrastructure has had to navigate the perpetual tension between immediate needs and long-term preparedness.
The loss of talented clinicians to opportunities abroad had already stretched thin the expertise available to navigate crises, and now those who remained found themselves fighting a war on terrain for which no training manual existed: caring for the critically ill in complete darkness, delivering babies by flashlight, keeping dialysis patients alive without power, watching helplessly as floodwaters transformed hospital basements into rivers, destroying medication stockpiles, medical records, and the very equipment that stands between life and death. When the power died, refrigeration failed. When refrigeration failed, vaccines spoiled and insulin degraded. This is what happens at the dangerous intersection where climate extremes collide with healthcare capacity, digital dependency, and supply chain brittleness—a lived reality where meteorological violence translates directly into medical crisis. The same storm that tore roofs also severed the lifelines keeping chronic disease patients alive.
The Economics of Survival: Can We Truly Build Resilience Into Healthcare?
Early estimates of economic-loss approximate US$5–15 billion across the region, and while Jamaica’s catastrophe bond will pay out for the first time, money cannot restore what was lost or unlive what was lived. Families grieved confirmed deaths even as they tried to find relatives, yet amid the devastation, a question emerged: was this catastrophe inevitable, or the predictable outcome of systems designed for a climate that no longer exists?
The traditional approach to healthcare resilience is fundamentally backward—waiting for disaster to strike, then responding with charitable aid and emergency relief. Melissa exposed the fatal flaw in this logic. Consider the mathematics: early estimates suggest $50 million invested beforehand in resilient backup power, distributed supply chains, and fortified facilities could have prevented hundreds of millions in losses and, more importantly, saved lives that charitable relief cannot restore. The question isn’t whether we can afford to invest in resilience – it’s whether we can afford not to.
So, who fixes the problem?
This reality surfaces a deeper question: should small island states bear these costs alone? As Barbados Prime Minister Mia Mottley has powerfully argued, there is a profound asymmetry at work, wherein those whose histories helped fuel industrialization now face disproportionate costs from its climate consequences. For Jamaica and its Caribbean neighbors, the question isn’t whether to build resilient healthcare systems, but how – and how soon.
What’s needed is a paradigm shift, one that treats climate adaptation not as charitable relief but as shared investment in global health security, recognizing that vulnerability anywhere threatens stability everywhere. The Inter-American Development Bank has championed this approach through its “One Caribbean” program, which explicitly frames climate adaptation and disaster-risk management as infrastructure priorities rather than emergency responses. This is the model we must embrace: we cannot continue treating climate adaptation as reactive emergency response. Instead, we must recognize it as the defining infrastructure investment of our generation, one that demands international cooperation, innovative financing, and a fundamental reimagining of how we protect the health of vulnerable populations in an era of climate volatility.
Jamaica’s response demonstrates what such leadership looks like in practice. Prime Minister Andrew Holness activated Jamaica’s catastrophe bond for the first time, unlocking critical funding, while Health Minister Dr. Christopher Tufton coordinated field hospitals alongside the Jamaica Defence Force to reach devastated communities. At the University Hospital of the West Indies, Medical Chief of Staff Dr. Carl Bruce maintained critical care as infrastructure collapsed. These leaders have shown up in the trenches with healthcare workers, soldiers, and communities who refused to wait for rescue, demonstrating that resilience is built by empowering those on the ground to lead their own recovery. The question now is whether the international community possesses the wisdom to learn from those navigating this crisis in real time, and the humility to support, rather than supplant, the leadership already emerging.
Rising From The Rubble
Hurricane Melissa will fade from news cycles, as disasters inevitably do. But the lessons being etched into Jamaica during these weeks of recovery must ripple outward into policy, practice, and preparation, carrying truths that transcend geography.
In the wreckage of collapsed hospitals and flooded clinics, Jamaica has the opportunity to draft something invaluable: a manual for healthcare resilience in an era of climate disruption. It will be written in the improvised solutions now being deployed—distributed data systems, mobile pharmacies, solar-powered equipment—and in the recognition that climate change demands fundamentally different approaches to care delivery. Small island states stand on the frontlines of climate disruption not by choice but by circumstance, yet that vulnerability can forge a laboratory for adaptation that the entire world will eventually need.
When the next Melissa arrives – and it will – we will face a choice. We can treat it as an anomaly, or recognize it for what Jamaica is teaching us: the new baseline, the conditions under which 21st-century healthcare must learn to function. Vulnerability anywhere threatens stability everywhere.
The human spirit’s determination to rise, as Angelou promised, remains unyielding. But it cannot rise alone.