Sobre las conciencias de los hombres: A medical ecological view on post-Maria Puerto Rico (Part 3)

In the final blog in his post-Maria Puerto Rico series, Timothy Dye, Editor-in-Chief of Maternal and Child Health Journal, discusses the progress of recovery in Puerto Rico and how not all communities and individuals have been able to return to normality at the same rate.

The landscape of Puerto Rico is surreal – re-sculpted and regenerated from the force of Hurricane Maria. Driving through the scenery, now more than two months after Maria, you see lots of green in many shades. The mountains are covered in foliage, but if you look closely, the contours of trees, mudslides and rocks are seen underneath.

More people have electricity now, though still only about half of the island’s population. While driving with a friend one night we turned from the highway into Santurce, where for some weeks there had been lights on only one side of the street, we saw lights on both sides. Excited by the possibility of electricity after 90 days, he ran to his apartment and basked in fans, lightbulbs, and appliances, texting me pictures for hours of electrical machinery.

The night the lights came on in one neighborhood

Many people have some source of water now, but it requires filtering, treatment with iodine, or boiling. People in Puerto Rico do this sometimes, but not always. They also speak of GI upset, but like many recent situations on the islands, this has become a part of life.

It definitely feels like wealthier folks got their lights back before less wealthy folks and that many of the higher income families have left the island altogether. I’ve heard many tales throughout the country of people working in restaurants and shops, who lost their jobs immediately after the hurricane when the small businesses were shuttered.

Neighborhood of Santurce

It seems difficult for the wealthier people to continue to stand together with their lower income neighbors as they did in the beginning of the crisis when the lack of electricity, lack of water, and damaged property was a great equalizer. But now, those who can access resources have moved back to their pre-Hurricane lives; but many can’t. The poverty rates of Puerto Rico vastly outpaced most other areas affiliated with the United States even before the recent crises; now income inequality and social and health disparities cannot help but divide even more.

Much of the population of Puerto Rico continues to rely on donated goods. I visited at least a dozen communities and the only supply distributions I saw were informal: set up by organizations like church groups, and social centers. I talked with one man in San Juan and he had no idea where to go for food or water; there was nothing visible in the vicinity of his neighborhood.

Donated supplies housed in a small church

Some places have been successful in garnering aid in terms of goods; but often the need far outstrips the ability to distribute. I saw stockrooms in churches burgeoning with goods – indeed those maintaining the stock were proud of what had been amassed – but these goods needed to get to those in need. Oddly, many organizations arrived in Puerto Rico with supplies but had no idea how to distribute them. Many asked our team for help identifying contacts, routes, towns in need and distribution channels. This strongly suggests that much of the aid arriving isn’t necessarily what’s needed or requested if there are not systems for distributing it.

San Juan, Puerto Rico

The final impression that struck me during my fourth trip to Puerto Rico since the hurricanes hit was the almost ubiquitous presence of opportunists. Some may see legitimate opportunities to partner economic development with communities and local industries, but many seemed to see an immediate chance to leverage the tragedies for their own economic benefit.

This unfortunately is not new: Puerto Rico has seen a long trail of failed investors, abandoned ideas, charlatans, and exploiters for centuries. The hurricanes have generated another wave of them, sometimes even seeming to leverage humanitarian aid for business opportunities.

The awareness of Puerto Rican people to these opportunists is strong; I heard many local people concerned that their country would lose land, people, and a quality of life without sustainable, engaged solutions.

The hurricanes created a devastation that continues to illuminate deep social disparities both old and new and creates a new urgency for justice and equity in the country.

Mural, Old San Juan

Humans are constantly being shaped by their environment. Damaging climatic events like Hurricanes have repercussions for health, social structure, politics, and affect the trajectory of the lives of the people directly impacted.

The devastation of Hurricanes Irma and Maria have become life markers for Puerto Ricans – what life was like before, and what life became after. Of course nature shapes us, and we it; but make no mistake, the suffering and systematic oppression of human populations results from human intent, action, and inaction.

We see before us a society – Puerto Rico – that means much to the world, has given much to the world, and the world now needs to stand alongside Puerto Rico and its citizens to recover, with equity, justice, and respect.

Drive through Punta Santiago, Humacao, Puerto Rico

You can read part 1 here and part 2 here.

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