Puerto Rico Emergency: UN Agencies Can Help Avert a Second Wave


After two successive monster hurricanes another ‘perfect storm’ is hovering over Puerto Rico. There's a real possibility that, without additional immediate humanitarian intervention, a second wave of destruction could hit the island in the form of disease outbreaks.

Just today (Sunday), Puerto Rico's Governor, Ricardo Nevares, said “my biggest concern going forward is public health emergencies.” He told CBS News that a handful of disease cases related to exposure to dirty water are being investigated.

During his one-day visit to Puerto Rico last week, what wasnt immediately visible to US President Donald Trump and his officials is what could likely come next: deadly disease outbreaks caused by the combination of a lack of clean drinking water, standing water that provides ideal breeding grounds for mosquitos carrying vector-borne diseases, high temperatures and people amassed in close quarters.

Also this weekend, in a letter to Trump,  Nevares called the situation "an unprecedented level of destruction." He added that its impossible for the island to meet the considerable human needs without additional support.

Puerto Rico's Governor send a letter to Trump asking for additional financial assistance following "unprecedented catastrophe."

Puerto Rico's Governor send a letter to Trump asking for additional financial assistance following "unprecedented catastrophe."

As someone who has worked many disasters around the world, I know that left unattended, diarrhea, dengue fever, measles, pneumonia, typhoid and even Zika can spread like wildfire in the conditions seen in Puerto Rico - a US possession which has one of the most backward medical systems in the country.

Even with thousands of US troops and Federal Emergency Management Agency (FEMA) officials on the ground, it is clear that the recovery effort is beyond the existing capacity. Although the militarization of the relief effort has been welcome, it has largely failed to deliver aid to the so-called last mile - small, remote communities where suffering is most acute.

Without additional resources and expertise, such as what is found in UN relief agencies, there's a real possibility that a second wave of destruction could hit.

Mass vaccination campaigns, at least addressing diseases for which vaccines exist, should have started several days ago.

The global humanitarian organization, Oxfam, slammed the US on Monday for failing to act in a robust an swift manner.

"Oxfam has monitored the response in Puerto Rico closely, and we are outraged at the slow and inadequate response the US government has mounted in Puerto Rico," Oxfam America President Abby Maxman said in a statement. "Clean water, food, fuel, electricity, and health care are in desperately short supply and quickly dwindling, and we're hearing excuses and criticism from the administration instead of a cohesive and compassionate response."

A big reason for this deplorable situation, three weeks after Hurricane Maria struck, is that many government officials and first responders are themselves disaster victims. Even if they are available, blocked roads and lack of fuel and communications makes it difficult to arrange deliveries of food, water fuel - and life-saving medicines. Poor planning on behalf of FEMA is also to blame  

As of Wednesday, half of Puerto Ricans did not have access to drinking water and only 5 percent of the island had electricity, according to FEMA. (The data was subsequently erased from the FEMA website, according to news reports).

As with most humanitarian emergencies, children are the most vulnerable - especially from acute watery diarrhea caused by drinking contaminated water. In Puerto Rico the situation is compounded by the fact that almost 60 percent of children live below the federal poverty level, a situation which often puts them last in line for recovery.

In the wake of the 2004 Indian Ocean earthquake and tsunami, which claimed the lives of more than 250,000 people, about half of them children, a second wave of death and disease outbreak was feared but averted because of quick action by UN and other aid organizations. Mass vaccination campaigns, something UN agencies such as UNICEF and the World Health Organization (WHO) are extremely well-equipped to conduct, are needed in Puerto Rico now.

In addition to having superb logistical expertise and resources, agencies such as the UN Office for Coordination of Humanitarian Affairs (OCHA) can provide everything from daily situation reports and analysis to emergency communications and mapping.

Because Puerto Rico is part of the United States, a wealthy, industrialized country, UN agencies do not have active programs in place. However they can intervene, as they did in the case of Katrina in 2005, when requested by Washington. In that disaster the UN's specialized food, health and children's agencies were mobilized. UNICEF sent 'School-in-a-Box' and recreation kits to hard hit areas.

Essential for the Puerto Rico response are the logistics and emergency experts who are a core part of UN agencies that routinely support natural disaster relief efforts. A request for their humanitarian assistance needs to come now, so that resources can be mobilized as quickly as possible. Many UN agencies have pioneered the ‘build back better’ approach to rebuilding - such as building more resilient schools and hospitals - and this could be beneficial for debt-burdened Puerto Rico in the long-term.

UN agencies are already active in many countries in the Caribbean, such as Haiti and Dominica, where they are augmenting the emergency response capacity of governments across the region. In the badly damaged Domica, WFP has deployed helicopters and boats to deliver high energy biscuits. WFP, the world's largest humanitarian agency with its own air lift service, already has operational hubs in the Barbados and Antigua, and an emergency hub in Panama. In the case of Puerto Rico, UN experts in New York and in regional offices could be deployed.

With a second wave of destruction a very real possibility in Puerto Rico, the US government must immediately invite the international humanitarian community to intervene, or be prepared to watch more Americans suffer through a horrific, preventable humanitarian crisis.