NEW YORK, United States (AFP) — Conditions in Puerto Rico are still heartbreaking more than five weeks after Hurricane Maria wrought devastation, with the lack of power and clean water compounding chronic conditions, medics say.

Doctor Kevin Munjal, assistant professor of emergency medicine, and nurse Stacey Conklin were part of a team from Mount Sinai Health System who worked 12-hours a day, seven days a week in tents, living on military-style MREs in Fajardo, in Puerto Rico’s hard-hit east.

When the generator in the local hospital failed, medics had to “bag” patients by hand who were on ventilators, said Conklin, after the team returned from a two-week mission treating more than 1,600 patients.

Health conditions included lacerations on people who cut themselves with machetes or chainsaws while trying to clear debris, dropped generators on their feet or sustained kerosene burns.

“People would tell us that for them to get to the main road, they were having to chop their way through to get out,” Munjal told AFP.

The lack of clean water means that viral and bacterial illnesses, such as conjunctivitis, norovirus and gastrointestinal infections, spread easily through people living in close quarters in shelters, they said.

Not only were there medication shortages, but the lack of power made long-term care difficult at home for those with chronic conditions.

“If we can get power back to the people I think that will end up solving a lot of the issues,” said Munjal. “Power and clean water will do more for health outcomes than more medical tents.”

He said he was moved by a woman in her 60s in considerable knee pain as a result of osteoarthritis.

“She has to stand in line everywhere to get the basic essentials, she was on the 16th floor of a building without power, so she had to go up 16 flights of stairs and down,” Munjal told AFP.

“Stories like that, really, I think break your heart.”

While an emergency prescription assistance program helps patients without insurance, others are falling through the gap if they have lost work and need to spend precious resources on food and clean water.

The US government has come under fire from Democrats who say the response has been woeful since Hurricane Maria hit the US territory of 3.4 million on September 20, two weeks after Hurricane Irma.

As team leader Conklin said she saw first-hand the huge logistical problems facing federal responders in a fluid disaster-response where communications were a challenge without adequate phone service.

“I think honestly that folks were doing the best that they can, but whether people realise that or not is a whole different story,” she told AFP.

Around 75 per cent of customers are still without electricity and clean water is still scarce in many areas.

“You have to wonder, if you had a state in the United States that went 36 days without power,” said New York’s Democratic Governor Andrew Cuomo on Thursday after a one-day visit. “People would be outraged.”