Fragility and Rule of Law in Puerto Rico
Compared to other countries in North and Central America, Puerto Rico is unique in terms of its fragility and rule of law. Puerto Rico is considered a U.S. territory and is subject to U.S. laws, but also has its own government and constitution, which passed through Congress in 1952. Joe Biden stands as the president of Puerto Rico, but a governor elected by Puerto Ricans also rules over the territory. Puerto Ricans have U.S. citizen status, but cannot vote in presidential elections and have no representatives in Congress. These contradictions mean that Puerto Rico is neither a state nor a sovereign country. Understanding fragility and the rule of law in Puerto Rico provides insight into the importance of aid to the nation in times of crisis.

The Statehood Debate

Because it is a U.S. territory, Puerto Rico is included in the U.S. Census data. According to the most recent data from July 2021, the poverty rate in Puerto Rico stood at 40.5% and the median household income between 2016-2020 stood at a little over $21,000.

Mississippi, the poorest state in the U.S., had a median household income of $45,792 in 2021, an amount $20,000 less than the national average, and a poverty rate of 19.6%. Puerto Rico is a U.S. territory, yet its poverty rate is more than twice as high as the poorest state in the U.S.

The past few decades have seen debates about statehood and Puerto Rico’s admission into the Union as a state. Puerto Rico has held six referendums over the years regarding statehood, the most recent one occurring in 2020. The majority of citizens voted for statehood but Congress ultimately has the final say in determining statehood. Even if statehood is something that Puerto Rico wants, that decision is entirely out of its hands. This important fact and poverty statistics partly explain the fragility and rule of law in Puerto Rico.

The Economic Factors

The debate over statehood ties into some of Puerto Rico’s economic woes as well. Because of its status, Puerto Rico uses the U.S. dollar as its currency and U.S. laws and policies oversee its businesses and trade policy. Puerto Ricans enjoy tax exemptions, but they receive far fewer social welfare benefits than people living in the U.S. even though the U.S. government considers them U.S. citizens. Puerto Ricans challenged some of these lack of benefits in court, such as Supplemental Security Income, but, ultimately, the cases saw no success.

The country is also in the middle of an economic recession due to massive debt. According to an article from Vox on Puerto Rico’s situation, the debt crisis began in 2014 when Puerto Rico had accumulated $72 billion worth of bond debt. Data from the Council on Foreign Relations shows that the debt in 2020 stood at about $70 billion, which is about 68% of Puerto Rico’s GDP. Puerto Rico turned its budget over to an independent board in Washington in order to help control its debt.

Hurricane Recovery

Hurricanes and their lingering effects on people and the economy exacerbate the fragility of Puerto Rico. Hurricane Fiona is fresh on everyone’s minds but Hurricane Maria (2017) had a more significant impact on the country.

An Amnesty International article from 2018 reveals personal accounts and statistics on the state of Puerto Rico one year after Maria. According to the article, “tens of thousands in Puerto Rico are still living under blue tarps, designed as temporary roofs.” Additionally, Federal Emergency Management Agency (FEMA) rejected about 62% of applications for home reconstruction aid at that time. Hurricane Maria also knocked out nearly 80% of the island’s energy grid and power had not been restored to the last house until a year later. Then, Hurricane Fiona hit in September 2022, dismantling much of the recovery process.

Many places on the island experienced flooding with some areas receiving as much as 30 inches of rain. In Puerto Rico, “overflowing waterways and the loss of power caused pumps to fail, leaving 70% of households and businesses that rely on the public water and sewer system without potable water,” The India Express says.

By September 2022, LUMA, the main power utility in Puerto Rico, restored power to more than 100,000 people out of the 1.5 million LUMA customers without power.

In addition, many facilities learned from the events of Hurricane Maria and employed generators — hospitals ran on backup generators during the storm. This is in stark contrast to the time of Hurricane Maria when many hospitals lost power during the storm and could not operate.

The United States Response

The White House is committed to helping Puerto Rico recover. During his speech in Puerto Rico on October 3, 2022, Biden promised that Puerto Rico will receive every dollar Congress approved in federal aid after Maria hit. In terms of aid, at the time of the speech, the U.S. sent $4 million to improve the resilience of Puerto Rico’s electricity grid.

During the first month of response since Biden declared the situation in Puerto Rico a disaster on September 21, 2022, FEMA provided more than $456 million in disaster relief to more than 600,000 families. In addition, Biden authorized FEMA to provide its services (Individual Assistance, Public Assistance and Hazard Mitigation) to all municipalities in Puerto Rico. The agency had also hired Puerto Ricans as temporary employees to assist with recovery efforts in order to reduce unemployment.

By improving issues regarding fragility and the rule of law in Puerto Rico, Puerto Rico can achieve stability in several critical areas.

– Matthew Wikfors
Photo: Flickr

Healthcare in Puerto Rico
Puerto Rico is a United States territory located east of Cuba with the Atlantic Ocean and the Caribbean Sea surrounding it. This beautiful tropical paradise is a land of wonder with picturesque landscapes for tourists and residents alike. However, behind this convincing guise is the reality of poverty and illness that plagues the country. With 43% of Puerto Rico living in poverty, the healthcare system is a system of great importance as it acts as a crutch to those living in poverty. Here is some information about healthcare in Puerto Rico.

Medicaid in Puerto Rico

Medicaid in Puerto Rico serves approximately half of Puerto Rico’s population of 3.2 million people. The Medicaid program in Puerto Rico is an outlier in comparison to other U.S. states, having to supply healthcare to those in need while facing shortages of doctors and funds. The annual healthcare budget in Puerto Rico is $367 million as of 2019, however, estimates determine that expenditures are closer to $2.8 billion.

Additionally, the Medicaid program operates on a Managed Care system. This system helps to manage cost, utilization and quality, making healthcare in Puerto Rico more affordable and offering better utilization of health resources.

Additional Funding

The Affordable Care Act, section 2005, provided the Medicaid program in Puerto Rico with $5.4 billion in additional Medicaid funding from July 1, 2011, to Sept 30, 2019. Puerto Rico also received an additional $925 million in funds to establish a healthcare market. The country had to exhaust Previous Affordable Care Act funds before it could use additional funds. The Affordable Care Act is a health reform law that passed in March 2010. The law has three goals including increasing the availability of affordable health insurance, expanding the coverage of the Medicaid program to cover adults below 138% of the federal poverty line and supporting innovative methods of medical care delivery to decrease costs of healthcare.

Doctors Leaving the Country

While medical professions receive respect and high pay in the U.S., this is not necessarily true for Puerto Rico. In fact, many Puerto Ricans enter the medical field so they can one day migrate to the mainland U.S.A. According to the Economic Research Institute, the annual average income for a Family Doctor is $194,307, while the U.S. average is $237,000.

Another issue that doctors in Puerto Rico are facing is the scarcity of medical equipment and personnel, often resulting in prolonged waiting times for appointments. According to Vox, the waitlist can take “as long as four to six months to see professionals,” a direct result of Puerto Rico losing approximately 15% of all medical personnel on the island.

Puerto Rico College of Physicians and Surgeons

Shortages in medical personnel and lack of funding have increased wait times and created shortages of medical supplies in Puerto Rico. Thankfully, the Puerto Rico College of Physician and Surgeons is working to combat these challenges. This organization emerged through Law 77 in 1994 and is mandatory for all students pursuing a career in the medical field. The Puerto Rican government uses it to provide doctors where people need them most. The Puerto Rico College of Physicians and Surgeons ensures that doctors studying in Puerto Rico serve there for sometime before finding opportunities elsewhere. As of 2016, the organization has lost approximately 4,000 members to the “temptation in accepting one of those lucrative job offers,” shrinking the number of members from 14,000 to 10,000.

Jaideliz Moreno

The state and quality of healthcare in Puerto Rico have fallen as the years pass by, proving to negatively affect the population. On a seemingly average day in Vieques, a small island off the coast of mainland Puerto Rico, Jaideliz Moreno developed flu-like symptoms. This is a common issue that people face on the mainland U.S.A., but it was a life or death situation for Jaideliz. This was because Vieques, recovering from the destruction that Hurricane Maria caused in 2017, lacked a proper hospital. A small clinic for veterans alongside a labor and delivery room has replaced the hospital that Hurricane Maria destroyed. The small clinic named Susana Centeno Community Health Center lacked the medical supplies necessary to cure 13-year-old Jaideliz Moreno. A helicopter rushed her to mainland Puerto Rico but she died on the way there.

FEMA —Federal Emergency Management Agency— is an agency that strives to support citizens and first responders to show that as a nation we work better together in the face of adversity and disaster. As of January 2020, FEMA has approved $39.5 million to fund the Susana Centeno Community Health Center until a permanent hospital in Vieques is built. As of now, there is no projected completion date of the Vieques hospital.

Healthcare in Puerto Rico is a developing system in need of vital resources and proper funding. This kind of support is key to the growth and improvement of Puerto Rico’s medical work.

– Ernesto Gaytan
Photo: Flickr

How to Help People in Puerto RicoOn September 20, 2017, Hurricane Maria battered the island of Puerto Rico, leaving the island’s energy grid destroyed and 3.4 million people without power. The governor of Puerto Rico estimated it could take a month or more to get electricity back to the whole island. The Puerto Rico Electric Power Authority (PREPA) stated it may take three to four months. Before explaining how to help people in Puerto Rico after Hurricane Maria, learn why restoring electricity quickly matters for this territory.

Restoring Energy to Puerto Rico

Electricity is an essential part of life, necessary for improving the lives of people around the world. In Puerto Rico, restoring energy is vital for restoring stability post-hurricane, as a lack of access can be devastating. The greatest impact is felt by women and children. According to the U.N., about 17,000 children die each day from causes that are preventable with sufficient electricity. This includes access to clean water, better sanitation, adequate food, medicine and more education to improve earning power—all things that can be taken for granted in the developed West. Restoring power to Puerto Rico is urgent. The lives of the world’s most vulnerable populations – women and children – are at stake.

Energy is also essential for economic development. When access to energy is impeded, daily life halts. Access to energy means that many people enjoy shorter work days, better transportation and healthier diets. Energy also increases productivity in agriculture and industrial fields. One form of energy that impacts the wealth of a country greatly is electricity. Losing access to electricity could have alarming consequences for Puerto Rico’s economy.

How to Help People in Puerto Rico After Hurricane Maria

Want to know how to help people in Puerto Rico after Hurricane Maria? The most crucial need is restoring power. Currently, PREPA is working with the Federal Emergency Management Agency and utility companies from New York, Georgia and Florida to restore power.

Another priority is aiding Puerto Rico in its clean up efforts. In a Los Angeles Times interview, local Sonia Viruet stated, “First we need help cleaning. We can try to do it ourselves but it will take too long.”

Finally, a priority to help people in Puerto Rico after Hurricane Maria is to provide them with basic human needs such as food, clothing and shelter. Some organizations helping to meet these needs are:

1. American Red Cross
2. ConPRmetidos – a Puerto Rico based non-profit
3. Unidos por Puerto Rico – created by the First Lady of Puerto Rico
6. Save the Children

Global Giving is another organizations meeting the immediate need for food, fuel, clean water, hygiene products and shelter. Once initial relief work is complete, this fund will transition to support longer-term recovery efforts run by local, vetted organizations responding to this disaster.

The recent landfalls of Hurricanes Irma and Maria have devastated the island of Puerto Rico. While the damage is grim, there is hope in the fact that the island has bounced back from catastrophic disasters before, such as in 1969 after Hurricane Hugo. With the aid of compassionate people, Puerto Rico should return to normalcy sooner than later.

Jeanine Thomas

Photo: Flickr