CIALES, Puerto Rico – He laid in bed in a fetal position in a room at the back of the house, a skinny elderly man, rigid with pain. He barely spoke, except to utter his outrage in Spanish curses. When a medic gently peeled back the bandages on his feet to examine weeping pus-filled sores, he writhed and shouted his indignation.

Long ago, Agostin Figueroa was a young soldier proudly marching off to Korea to fight for his country. The 87-year-old did his training at Fort Jackson in South Carolina, he said reluctantly – with eyes squeezed shut. Did he run a lot? “Bastante” he said, almost in a shout. “Quite enough.”

The war stole his serenity and he became an alcoholic, said Javier Morales, a fellow veteran who had come to check on him. After Figueroa suffered a stroke and was attacked by local hooligans who took his disability money, his sister, Ana Delia, had a room built at the back of her house for him.

Hurricane Maria was the last straw.

Ana Delia Figueroa walked up to the locked fence at the edge of her driveway in her housecoat. She was distraught and could not find the key to the fence. She and her two daughters — all trained as nurses — have tried hard to care for her brother, but his condition is deteriorating, she said. She can’t eat, hasn’t slept. She broke down in sobs.

Still, she said she can take care of him. “Don’t take him away,” she told paramedic Winnie Romeril. She started to cry again.

Romeril, who had been examining Agostin Figueroa, eyed his caregiver closely. Ana Delia is a diabetic. Romeril, a professional air rescue paramedic from Prattsburgh, New York who had been in Puerto Rico for over a month volunteering with the Red Cross, tested her blood sugar and it was spiking. Ana Delia took her insulin and was more composed.

Across this island territory, the sick and the elderly have become even more vulnerable since Sept. 20, when Hurricane Maria’s 150-mph winds, tornado-like gusts and slamming rains hammered Puerto Rico for more than 20 hours, devastating infrastructure.

Seven weeks after Maria, there are tens of thousands of Puerto Ricans in the island’s interior are barely subsisting. Homes in the mountainous terrain are isolated and officials estimate they could remain without power or water for six months to a year. About 18 percent of Puerto Rico’s 3.4 million people are over 65, and as the elderly age, it often falls to family members to care for them. Many have minimal resources; limited -- if any – infrastructure; and outsized risk, particularly among the sick and elderly.

Many are living in moldy conditions, unable to refrigerate food or medications. Even the hardiest are suffering.

“This is what we are seeing in all the houses,” Romeril said. “Even under the heroic wonderful condition of care – three nurses in the family – they can’t stave off infection because of the conditions.”

The top commander of the U.S. military response pulled out last week, along with troops and helicopters, saying it was time to transition to the next phase of recovery. But the most vulnerable – among them the island’s aging veterans – are still overwhelmed.

Beneath calm, chaos

The Figueroa single-story house appeared to have weathered the storm fairly well. The yard was cleanly trimmed, and abstract white sculptures shaped like swans adorned the front yard. A concrete staircase with a pretty cement balustrade led to the rooftop.

Next door, gardeners worked on a yard, a chainsaw buzzing in the afternoon heat.

But look more closely and all is not well in this well-manicured neighborhood at the edge of Puerto Rico’s central mountains. The saw was not the sound of suburban manicuring. It was of toppled trees being cut to support a home balanced perilously on a collapsing foundation pillar.

Just two months ago, the rooftop of the Figueroa home was the floor of a second story. All that’s left are two tiled walls of a bathroom, strangely supporting a toilet and sink under the hot Caribbean sun.

Maria took away the rest of it.

From house to house, Javier Morales has been finding similar situations. For weeks, the former president of the 65th Infantry Veterans Association in Puerto Rico has been checking on the most vulnerable of the island’s nearly 100,000 veterans.

He was in the states when Maria struck, he said, and when he returned to a home without electricity or hot water, he fell into a depression.

Then it dawned on him, he said, that veterans might need his help. He started visiting those who were sick or immobile, and has been making the rounds ever since.

Some just need supplies, and he could see improvement in them once they realize they are not alone.

“The way they approached me – they were happy,” Morales said. “That’s gratifying.”

Others are ailing. His cousin Nestor Morales Gonzalez, 85, is caring for his sick wife, Luz, 72. She had several strokes after being treated for a brain tumor, and she can’t get the words out. She lay muttering in their bedroom, where bottles of medication shared the dresser space with photos of their grown children, while Nestor tried to make her comfortable. Recently, she took a fall and her right foot rested on the bed at an unnatural angle.

She was 16 when they married 55 years ago. Now, in their photo-filled home, Nestor struggled to maintain his composure.

Javier Morales worried for his cousin. Their son, who was with them through the storm, returned home, leaving Nestor alone to care for his wife. “If he falls, who is going to find him?” Javier Morales asked.

Veterans in distress

Across the street, another family watched helplessly as their elderly mother lay in pain on a bed in an airy room off the front porch. She is the last survivor of her generation, her son Juan Batista said.

Morales said the VA, which also has its hands full, is not as responsive as he wishes they would be. A lot of these families end up having to fend for themselves, he said.

“Veterans should be able to get help,” he said. “It’s frustrating. There should be a place to go where they help them.”

The VA has reopened all but two of its clinics on the island, and medical aid tents were set up outside the other two. They’ve also created medical shelters to house veterans in distress.

Outside Agostin Figueroa’s room, Romeril worked from a list of those shelters, calling and hoping one would agree to take him. His feet were infected and his catheter was cloudy – suggesting he has a urinary tract infection, she said. But she only got a voicemail and after leaving a message, called the local ambulance.

Ana Delia Figueroa had been reluctant to send her brother back to the hospital. She was afraid he will die there, Morales said.

Romeril finally persuaded her to let the ambulance come.

Agostin Figueroa shouted his pain as they roll him to the ambulance.

With no electricity or running water, spotty communications and scant supplies, even the nurses in the family are outmatched, Romeril said with a shake of the head.

“I said, ‘You guys are doing a heroic job,’” she recounted. “I know you could take care of him – except for Maria.”

cahn.dianna@stripes.com Twitter: @DiannaCahn

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