The speed and quality of the federal response to Hurricane Maria’s devastating toll on Puerto Rico and the US Virgin Islands continues to draw scrutiny. Two weeks after the storm’s landfall on US soil, wide swaths of the islands are still without electricity, telecommunication lines, medical care, fuel, clean water, cash currency, and other necessities. Many rural communities remain physically inaccessible. Only 13,832 households in Puerto Rico have applied for Federal Emergency Management Agency assistance, a number much lower than after other disasters of similar intensity and damage.
Because of the increasing frequency of natural disasters, we know the quality and robustness of response and relief will have deep repercussions for recovery of the island’s people, homes, and communities.
The most immediate consequence of disasters is their toll on human life. Death counts rise after the event largely because of search and rescue findings. Other people do not survive the wounds and pain inflicted during the disaster. But a more insidious cause is people’s inability to access medical care for disaster-induced emergencies and for prior medical conditions. Sustained gaps in medical access in Maria’s wake are likely to extend the counting process and increase the overall death count.
But death counts do not foretell recovery. Low immediate death counts often yield reductions in attention, resources, and will for recovery. Many medical cases may be life threatening, but most will lead to conditions that produce physical pain and incapacitate victims from employment and their regular lives for years to come.
Other health effects will play out during recovery beyond physiological wounds and care gaps. Many of them are unknown at this point because they were not monitored before the disaster.
Environmental hazards are often exacerbated by disasters, such as the massive release of toxins from a breach in a manufacturing plant or a waste site. The US witnessed this following Hurricane Harvey, as the media outlets and public health departments that tracked air and floodwater toxicity warned Houstonians to avoid the water that surrounded them. Status reports from the US Environmental Protection Agency and local environmental agencies are just starting to emerge about hazard sites and debris across the islands. The effects of these hazards will continue for years.
In addition to the toll on physical lives, the mental health of victims will suffer. Postdisaster studies have shown the detrimental effects of severe trauma, especially on children. This trauma is compounded when relief and response are delayed.
Disasters are the confluence of an external hazard striking where people live and work. Failure to prepare houses physically for likely hazards and to secure insurance to mitigate the costs of rebuilding means that most US homes are unprepared for what could come. This was true in Puerto Rico and the US Virgin Islands, as less than 1 percent of homeowners in Puerto Rico have flood insurance and only 50 percent have wind insurance. Current property damage estimates range widely and will require massive assistance beyond what is being considered.
Delays in response have two unexpected consequences on recovery. The first involves people attempting to recover possessions and repair their homes without proper safety precautions and construction knowledge, often because of relief delays and distrust in public assistance. Many well-intentioned charities have contributed to this chaos in past disasters. The desire for stability and normalcy is strong, but poor immediate choices can shape home quality, property values, and family budgets. A longer relief phase creates a bigger window for bad choices, especially where building codes are weak and poorly enforced.
Second, hurricane damages can get worse if not attended to immediately. Water deteriorates structural and finish materials, and, even when floodwaters recede, moisture damage leads to mold and mildew that make matters worse. Delays in the relief that typically comprises debris removal and tear-downs could increase the number of uninhabitable homes beyond those wrecked during the hurricane.
Beyond individuals, the rush to rebuild after a prolonged relief phase could lead to a failure to enact better building codes and better enforcement, the institutions that produce better housing. After Hurricane Katrina, haphazard code enforcement and flood mitigation maps led to staggered home elevations. Rural municipios (county subdivisions) in Puerto Rico already suffered from poor administrative resources, but there are signs that institution building rather than rebuilding what was there actually works. In Florida, though, better building codes adopted after Hurricane Andrew have proven to be the lifesaving factor that helped the state’s residents withstand Hurricane Irma.
Similarly, knee-jerk requests for massive new seawalls and other defensive infrastructure may lead to poor investments. Thoughtful and difficult conversations about whether and how people should recover in existing communities become less tenable when suffering persists during relief. Opportunities for better physical communities—the quality of rebuilt homes, the thoughtful planning of cities and infrastructure, and the possible relocation of families—dim in poor relief and response scenarios. Puerto Rico’s predisaster financial crisis will also give credence to the calls for purportedly cost-efficient “infrastructure as usual.”
Of course, these decisions may be moot. The mass displacement and resettlement of victims to other states and countries are becoming common. With the likely relocation of tens of thousands of Puerto Ricans to the US mainland, combined with the devastating effects of the island's financial crisis before the hurricane, the relief and response delays to Maria may radically alter communities’ demographics and the relationships of victims to their hometowns.
But there is hope that those remaining in “la isla del encanto” (the island of enchantment) will survive the disaster and cut through the detritus of relief and response to be a model with the help of those who leave. For the US to recover from the current season of disasters, though, we must learn to plant the seeds of comprehensive preparation and thoughtful response.