Just over a week after Hurricane Irma devastated the island and neighbouring St Barthelemy, killing 15 people, pools of stagnant water and mounds of trash seem to be the new normal. Add to that the absence of fresh running water, and the situation is ripe for a health epidemic.
“Yes, there are risks of outbreaks,” said Annick Girardin, the French minister for overseas affairs, who spent a week on St Martin following the Category five storm. “There is an existing problem on the issue of contaminated water, the issue of trash, basically the issue of hygiene.”
In poorer neighbourhoods where many families were not able to evacuate, residents fear the spread of mosquitoes – which can carry diseases ranging from Zika and dengue fever to chikungunya.
“My son has a fever maybe due to a mosquito,” said Natacha, a resident in the Sandy Ground neighbourhood near Marigot. “We will have to clean to prevent too many mosquitoes, or else there will be outbreaks. But it's difficult without water. If we get sick, we'll have to go to Guadeloupe”.
According to an AFP journalist, in some neighbourhoods like Concordia, control programs had begun on Wednesday.
The island, which is still struggling to get its electricity and telecommunications systems back up and running, has found it difficult to reach residents and warn them about the potential health risks.
To get the word out, the French government has distributed notices and posters in French, Spanish, English and Creole.
Still, French health minister Agnes Buzyn said, “We realise there are people on the island, in certain neighbourhoods, who are not following health instructions”.
One of the most important notices reminds people that only bottled water is safe to consume, and that if it is unavailable, boiling water before use is paramount.
“We hand out fresh water all over the territory, but it remains difficult,” Buzyn said. “There are zones not easily accessed, people that maybe we haven't been able to reach.”
According to the government, 150,000 bottles of water are being distributed to residents every day. But some people have still been fetching water directly from a reservoir.
A desalination plant destined for St Martin arrived Friday on Pointe-a-Pitre, on the French island of Guadeloupe, about 300 kilometres away. It will continue its journey to the hurricane-hit island by barge and is expected to be operational by September 25th, the authorities said.
Meanwhile drinking water has returned to St Barts, which is now able to produce about 800 cubic metres (176,000 gallons) a day.
“We are not yet at a level of signalling an outbreak, far from it,” Buzyn said. “Today, it's mostly an individual risk, which means it is essential that people who live on St Martin drink the bottled water that is distributed”.
Buzyn had said last Wednesday that there had been some cases of children with diarrhoea, but did not mention any signs of an outbreak.
Racing the clock
Medical epidemiologists are aware of and on the lookout for any sign of outbreaks, and will regularly track patients using health surveys, said Guadeloupe's public health director Patrice Richard.
On Saturday, St Martin's health services coordinator Sergio Albarello said there had been no cases of outbreak on the island.
“As of now, there have been no reported cases” of outbreak, he told reporters, adding that as far as mosquitoes, “we are not talking about carriers of genes that are epidemiologically relevant”.
And while many buildings were flattened by the storm, the St Martin hospital is still able to treat people “in excellent conditions”, even though one of its buildings was partially destroyed.
Philippe Gustin, the French envoy in charge of the islands' reconstruction, said the immediate plan was to fix the damaged buildings.
According to Gustin, about 30 percent of the buildings on the French side of the island were completely destroyed, but he cautioned that teams were still putting together a final estimate of damages — which has been put at €1 billion ($1.2 billion) or more for roads and buildings.
But repairing them before the high season, which usually starts in November and runs until April, seems nearly impossible. Cleaning up also remains a priority for St Martin, particularly in areas where rats could proliferate.
Home to some 35,000 people, St Martin — whose livelihood rests almost entirely on tourists — attracts around two million visitors a year, most of them American cruise ship passengers.
While visiting St Barts this past week, French President Emmanuel Macron promised emergency financial aid for those “who have lost everything”.
As for the Dutch side of the island, the Dutch Red Cross said Saturday that it had collected €13.3 million following a weeklong donation drive.
By AFP's Cécile Azzaro