Much has already been written about Hurricane Maria’s devastating effects on Puerto Rico in September 2017 and afterwards. More than 3,000 died from the hurricane and its aftermath, including extended loss of electricity, lack of safe drinking water, and disruption of transportation and supply chains causing a lack of access to medical care.
The National Institute of Standards and Technology (NIST) is conducting a deep study of the hurricane’s effects and recovery with a view to developing disaster resilience recommendations for Puerto Rico and the United States as a whole.
What went wrong?
“Hurricane Maria set off a cascade of building and infrastructure failures across Puerto Rico that had lasting impacts on society, including health care, business and education,” NIST reported. “The steep mountains of Puerto Rico also intensified the rainfall, [which] destroyed roads and bridges, blocking routes to hospitals and shelters for those who badly needed them. The hospitals and shelters themselves were heavily damaged by the storm, lifesaving medical equipment was destroyed, and parts of the buildings became uninhabitable. Each of these impacts intensified others. For example, the loss of electricity made it more difficult to move patients and supplies within some hospitals because elevators stopped working.”
The loss of electricity had ongoing health effects. Patients were unable to received essential dialysis or to refrigerate insulin; this is especially important in Puerto Rico, which has an unusually high prevalence of diabetes and kidney disease. Home oxygen machines also needed electricity. Refrigeration of food and safe cooking were also disrupted, leading to food safety issues. Again, these issues were especially dangerous in Puerto Rico, which has an older population and higher levels of chronic diseases.
NIST also found that many deaths were the result of a lack of medical care. Damage to medical facilities and lack of transportation meant that some people were unable to reach medical facilities or even to be reached by medical professionals. Altogether, only about 10% of the deaths from Hurricane Maria were the result of injuries sustained during the hurricane. The remainder took place in the following days and weeks, resulting from flooding, electricity failures, and other longer term results of the storm.
NIST also found that most residents didn’t take preparedness measures like moving to higher ground, evacuating, or following prepared emergency plans.
What went right
Schools and hospitals which had emergency plans and implemented them had much better outcomes than those that did not. Unfortunately, leaky roofs and damaged buildings caused significant problems. Buildings which were in good condition were less likely to have problems but many were not in good repair before the hurricane.
In the same way, people who made preparations before the storm’s landfall — including those shown above — had better outcomes than those who did not. A focus on preparation and communication benefitted communities.
What NIST didn’t mention
Studies published in the British Medical Journal conclude that Puerto Rico received less support and slower response from the federal government than did Texas and Florida, both of which experienced hurricanes in the same year. The inequity reflects the fact that both Texas and Florida have full representation in Congress, while Puerto Rico does not.
“The US federal government responded unequally to the three hurricanes,” one study says bluntly, “spending more money and resources more expediently for Harvey and Irma compared with Maria, ultimately detrimental to Puerto Rico with probable effects on long-term health and other inequities.”
“Our results show that the federal response was faster and more generous across measures of money and staffing to Hurricanes Harvey and Irma in Texas and Florida, compared with Hurricane Maria in Puerto Rico,” the researchers continue, following up with extensive details.
Among the specific issues discussed in the report was the difficulty in receiving funds allocated by Congress, and difficulties in getting those allocations. The researchers note that PROMESA, the financial oversight law passed in 2016, required the Governor of Puerto Rico to prepare 12- and 24-month recovery plans which had to be approved by the Financial Management and Oversight Board and then to send monthly reports to Congress. Texas and Florida faced no such obstacles. A Government Accountability report at the time pointed out the many ways in which what they decided as “red tape” slowed and hindered the federal response to the disaster.
“Disaster appropriation funding to Puerto Rico took over 4 months post-landfall to reach a comparable amount of money received by Florida and Texas in half the amount of time,” wrote the researchers. “The additional 2 months to distribute critical aid is not likely explained by geography, but likely a product of the congressional negotiations outlined above.”
A product, that is, of Puerto Rico’s territory status. As states, Florida and Texas had senators and voting members of the House of Representatives to advocate and to vote for their support. As long as Puerto Rico remains a territory, we can expect to face inequities like these. Reach out to your representatives and let them know that you support statehood for Puerto Rico.
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