Thousands of people with kidney disease in Puerto Rico are at risk due to power outages in the aftermath of Hurricane Maria.

It’s one of the most pressing health issues facing residents of the U.S. territory dealing with scores of medical crises in the aftermath of a hurricane that has knocked out power.

Hospitals running on generators are low on power, and conditions on the ground are ripe for the spread of disease.

People with kidney disease are especially at risk because they need to get dialysis roughly three times a week or they will die. But the dialysis centers, which need power and water to operate, are short on diesel fuel for their generators. And many patients do not have fuel for their cars to get to the centers in the first place.

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Mike Spigler, vice president of patient services at the American Kidney Fund, said that it is an “extremely tenuous situation” for the roughly 5,000 people on the island who rely on dialysis to stay alive.

The dialysis centers need diesel fuel to power their generators and “a lot of them are down to a day or two of fuel,” he said.

Trucks with gas are having difficulty travelling and are in short supply. “There's no real dependability on when these trucks are going to show up,” Spigler said.

Congressional Democrats are pressing the Trump administration to do more.

“We have had people who need dialysis who have been without it for 9 days,” House Democratic Whip Steny Hoyer (Md.) said at a press conference Thursday. “They are at risk and some have already died. This is a humanitarian crisis and demands the speediest, most robust reaction and action that we can take.”

Hoyer said he had spoken with Health and Human Services Secretary Tom Price Thomas (Tom) Edmunds PriceConspicuous by their absence from the Republican Convention Coronavirus Report: The Hill's Steve Clemons interviews Chris Christie Trump flails as audience dwindles and ratings plummet MORE on Thursday about the response to the kidney disease patients. Price resigned on Friday over his use of private jets for government business.

“We must get patients out of #PuertoRico and to the care they need,” Senate Democratic Leader Chuck Schumer Chuck SchumerPelosi orders Capitol flags at half-staff to honor Ginsburg Ginsburg in statement before her death said she wished not to be replaced until next president is sworn in Democrats call for NRA Foundation to be prohibited from receiving donations from federal employees MORE (N.Y.) tweeted Thursday. “@HHSGov can and must do more.”

FEMA said that as of Thursday more than half of the dialysis centers in Puerto Rico are open and the agency is working to evacuate people to the continental United States.

The Kidney Fund says there are reports of three deaths so far from people who could not get to dialysis centers, but it will take more time to get a full accounting.

The need for dialysis is far from the only medical crisis on Puerto Rico.

One hospital told NPR that it was forced to discharge 40 patients when it ran out of diesel to power its generators.

Dr. Peter Hotez, a disease expert at Baylor University, wrote in a blog post that Cholera outbreaks on Puerto Rico are a risk, given reports that as much as 60 percent of the population does not have access to clean water.

“These factors – the presence of the V. cholerae bacterium, poverty, collapsed infrastructure and lack of potable water access – create a toxic mix that could promote cholera outbreaks in Puerto Rico during the coming days and weeks,” he wrote.

Democrats on the House Oversight Committee cited examples like these in demanding on Friday an emergency hearing on the crisis in Puerto Rico.

FEMA reported that 25 out of 69 hospitals on the island are not operational.

Robyn Bash, a vice president at the American Hospital Association, said that almost all the hospitals they have had reports from are relying on generators as their only source of power.

She said the association had been in touch with HHS about a hospital worried that it is running low on fuel for its generator.

Both the Kidney Fund and hospital association said that simply getting in touch with people for information has been very difficult, given that cell service is largely down.

“We remain concerned about fuel, about water, and about the overall power supply situation,” Bash said.