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President Trump spent Sunday attacking NFL players for protesting racial injustice and inequality by taking a knee during the national anthem. While he exercised his aging white man outrage on Twitter, millions of Americans in Puerto Rico were without power and some of the island’s most vulnerable resident faced perilous conditions with no relief in sight following Hurricane Maria’s pummeling.

Maria hit Puerto Rico on Wednesday morning with the force of a Category 4 storm, leaving the entire island without power. The magnitude of Maria’s damage hasn’t been fully assessed; 20 municipalities remain cut off from any line of communication with the governor’s office. Jennifer Gonzales, the island’s nonvoting representative in Congress, said that Puerto Rico’s landscape was utterly decimated by the storm.

“The devastation in Puerto Rico has set us back nearly 20 to 30 years. I can’t deny that the Puerto Rico of now is different from that of a week ago,” Gonzalez told the Associated Press. “The destruction of properties, of flattened structures, of families without homes, of debris everywhere. The island’s greenery is gone.”

Armando Valdés, a journalist for Metro Puerto Rico, shared a particularly harrowing tale of the islands’ elderly on Sunday night—200 of whom were stranded in a high rise without food or drinkable water:

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“We did what we could, brought water for drinking and hygiene, cleaned public areas and emptied overflowing trash bins, got sick people on ambulances and took one other man to a shelter,” Valdés wrote. “That being said, the hurricane was just the beginning. The real crisis is now.”

Puerto Rico’s electricity could take months to restore and Maria’s wrath only compounded pre-storm debt problems. The island’s severely damaged ports, The Washington Post reported, have significantly hindered federal agencies’ relief effort. While food, clean water, and gas were delivered to the island, many roads remain inaccessible, making delivery nearly impossible.

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San Juan Mayor Yulín Cruz told The Post that the destruction in the island’s capital was horrific. “There is horror in the streets,” Cruz said, nearing tears. “There is no electricity in Puerto Rico. People are actually becoming prisoners in their own homes.”

Lack of access to life-sustaining medicine coupled with an ongoing heatwave now threaten to exacerbate the crisis. The death toll rose to 10 on Sunday, but officials have warned more people could drown in dire flooding.

Given the amount of time Trump seems to spend on Twitter, bitterly tweeting about the NFL, his silence on 3.5 million Americans, thousands of whom have lost everything, amidst one the worst natural disasters in their lifetimes is characteristic, but nonetheless deafening.