We Have An Obligation To Provide Aid To Our Fellow Americans In Puerto Rico

It is shameful that we haven't acted quicker and more deliberately.

“We are the world’s best at logistics. Tell us where you want to go, and we will build a road to get there.”

That’s what Lt. Colonel Michael Foster of the US Army 82nd Airborne told me about the Army’s capabilities while we were working together on relief efforts soon after the 2010 Haiti earthquake that killed at least 100,000 people.

At the time, I was serving as Medical Director of the largest displacement camp in Port-Au-Prince.  The camp provided shelter and care to over 60,000 Haitians while the recovery effort began.

In the aftermath of Hurricane Maria, the lessons of Haiti are clear to me.

While the nature of the challenges in Haiti were different than in Puerto Rico, they also have a lot in common. Both are impoverished islands. Both suffered massive damage to already-crumbling infrastructure. And both faced the possibility of epidemic-level disease outbreaks in the aftermath of the natural disasters they confronted.

I have no interest in contributing to the blame game that threatens to impede the current recovery effort. That sort of approach won’t produce one drop of drinking water, one vaccination, or one bed for children who lost their homes.

However, there is no avoiding the fact that so far, the U.S. response to our fellow countrymen has been lackluster and slow, at best. Our responsibility to help is beyond question. The victims of Hurricane Maria are taxpaying American citizens, and every American citizen has the right to expect that their country will come to their immediate assistance in the face of disaster. That’s true whether they live in Texas, Florida, or Puerto Rico.

The needs are clear. The resources are available. And our military is trained, ready, and willing.

Unlike in Haiti, where tens of thousands of people were hurt or killed by collapsing buildings and other “crush” injuries, the needs in Puerto Rico revolve primarily around preventing a massive health crisis caused by the lack of water and power. 

The biggest threats to the public’s health are dehydration; the lack of food, medicine, and hospital capacity; and communicable diseases, especially as we move into flu season.

Most Puerto Ricans survived the initial onslaught from the hurricane itself, but the potential impact is far from over. Unless we act immediately, thousands of our fellow Americans in Puerto Rico will be at risk, and the death toll caused by Maria could increase dramatically. 

Our number one priority has to be reestablishing a clean water supply, which in turn, requires restoring the electrical grid. And we need to establish an adequate and sustainable food supply chain.

As of today, a majority of Puerto Ricans still don’t have adequate access to safe drinking water or electricity, and only half the island’s roads are open. 

It’s simply not possible to provide adequate amounts of bottled water to 3 million people."

Without clean water, hundreds of thousands of people are at risk of contracting diarrheal diseases that cause life-threating dehydration. Children under the age of five are particularly vulnerable, because they have underdeveloped immune systems, and because their smaller size and their metabolism makes them more susceptible to severe dehydration, and faster. 

Ensuring an adequate supply of clean water requires infrastructure that can filter and deliver water in major cities and beyond. It’s simply not possible to provide adequate amounts of bottled water to 3 million people. 

There has been much discussion about the number of people we’ve put on the ground, but that really misses the point. There’s little benefit to sending people without the skills and know-how to address the critical problems. Instead, we should be focusing on capabilities, by 1) providing the capability to properly filter and deliver water; 2) rebuilding electrical capacity; and 3) reestablishing life-saving medical capability in major population centers.

We need to repair every airport in Puerto Rico so they can accommodate fixed wing aircraft that can deliver repair equipment and supplies. We need to quickly reopen roads and ports so food and supplies can be delivered across the island. We need to restore power as quickly as possible, so hospitals can become operational, and people can tend to their daily needs. We need to ensure adequate sewage treatment to prevent rampant illness. And we need to create camps for internally displaced people, where we can provide food, water, sanitation, and medical care in a coordinated and organized fashion.

That’s why the experience and capabilities of the military is so critical. The military has unparalleled capacity to clear roads, restore power and water filtration, airdrop water filters and food to remote areas, provide sewage control, and build temporary shelter.

American troops are the best in the world at logistics, whether D-Day, the Berlin Airlift, or the Haiti earthquake.

Finally, we also need a much better on-the-ground assessment of needs. It’s shameful that we haven’t acted more quickly and aggressively.  Our fellow Americans are in dire need, and we have a moral obligation to act.