That is the biggest load of unintelligible bullshit I have ever seen. It's 69 pages of redundant language and total guesswork.
From Execcutive Summary:
"Our study shows that physician lack of awareness of appropriate death certification practices after a natural disaster and the Government of Puerto Rico’s lack of communication about death certificate reporting prior to the 2017 hurricane season limited the count of deaths that were reported as related to Hurricane MarÃa"
In Other words, Doctors in PR too stupid to accurately report, and government in PR too inept to report.
Hence need outside study from GWU, to #1arrive at statistics which support the greatest amount of money to PR for the disaster. and #2 serve partisan political purposes.
**Since leaving the Paris Climate Accords, Der Fuhrer Trump has been responsible for twelvty gazillion dead babies, mostly brown ones.
Doctores in countries with dead brown babies, don't know how to count yet. Countries with brown babies,, don't know how to count.
So countries with dead brown babies, need outside experts, from George Washington School of Public Health, to count dead brown babies, on paper, submit final estimates to media, and fill out aid reuests.
So if your town has a natural disaster, or can just use more money from aid, hire GWU; a proven resource in the field of casualty countin' and reportin' and dat stuff, when dealin wif doctores what can't count.