Puerto Rico's Children Need Our Help
My earliest memories are of picking flowers off the hibiscus bushes in our backyard near San Juan, and running my fingers over the delicate red petals and powdery, sticky pollen at the center. I remember watching the wind — like magic — lift a kite into the sky near the centuries-old fortress, El Morro. I remember eating papaya that my grandmother would cut into pieces, douse in lime and sugar, and serve in her best crystal bowl. I remember one-floor stucco houses, places that felt solid and safe, yet open to visitors during the day, and the sound of coqui frogs at night. Puerto Rico — where I spent my earliest years — values its children. But these children are especially vulnerable in the aftermath of Hurricanes Maria and Irma.
Because of limited communication with the island, it is still difficult to know the reality on the ground. What we do know with certainty is troubling. Much of the island will be without power for another six months. Clean water is scarce, with 55 percent of Puerto Ricans still lacking clean drinking water after the storm. Aid is slow to arrive and underwhelming, despite the administration’s self-congratulatory response. Although the reports may be incomplete, what we are hearing and what we do know about children’s unique needs during natural disasters should make us worry.
Before his or her third birthday, a child’s brain will make hundreds of new connections every second through a process that is highly sensitive to environmental influences. This means that what a child experiences today can affect their neural development profoundly, with long-term consequences for learning and behavior.
In Puerto Rico, people are, to say the least, tired, stressed, and uncomfortable, even in places where the property damage has been relatively minor or aid has been accessible. A relative explained to me that, without electricity, “the nights are hot and noisy, so sound sleep is impossible.” When family members are worried and exhausted, children mirror those responses and eventually internalize that stress.
It’s no surprise, then, that children are especially susceptible to mental health issues during and after natural disasters. In the month after Hurricane Katrina, about 17 percent of New Orleans residents reported mental health issues, including post-traumatic stress symptoms like flashbacks and nightmares. Among children, the rate was 37 percent.
In addition to greater susceptibility to psychological stress, children are also different from adults in their vulnerability to illness. Children’s bodies are not tiny versions of adults’ bodies; they don’t move or interact with the world like ours, and they process food and water differently. Infants and toddlers are more likely than adults to contract illnesses after a disaster, due to their relatively immature immune systems. Children’s small size means they develop dehydration, malnutrition, and fatigue more quickly than adults. And they can be more prone to respiratory illnesses and asthma — a potentially serious problem, given Puerto Rico’s tropical climate. As in hot and humid New Orleans, in Puerto Rico the moisture left behind by hurricanes like Irma and Maria can get trapped in walls, producing indoor mold. When inhaled, mold spores can devastate the respiratory system and perhaps even the nervous system.
The good news is that we know what children need. The basic requirements of individuals involved in disasters include food, shelter, and sanitation. Next, children need the comfort of routine. Establishing predictable, regular routines can promote resilience in children and help them cope better with disasters. Reestablishing schools — including Head Start centers — is one of the practices most highly endorsed by humanitarian agency leaders with disaster experience. Pediatricians who have worked in disaster relief areas — including the Philippines after 2013’s Typhoon Yolanda, Haiti after the 2010 earthquake, and Thailand after the 2004 Indian Ocean earthquake — find that books and “comfort kits” with simple items like squeeze balls, finger puppets, and crayons are also soothing. For children who have lost everything, having a tangible book or toy that helps them be kids again can work wonders.
I can’t help but think of how different Puerto Rico is now, compared to my memories, and even compared to what it was a few weeks ago. Instead of exploring hibiscus bushes, children see trees uprooted by 150-mile per hour winds. Instead of eating papaya from a neighbor’s backyard — impossible now that storms have destroyed the island’s agriculture — grandmothers are rationing crackers and rainwater to feed their grandchildren. Instead of going to sleep in sturdy, stable homes, some families are homeless. The same wind that lifted kites into the sky roared through and around houses, terrifying adults and children alike. Maybe that sound, deafening and terrible, has erased the coquis’ chirps.
The 175,000 children under age four who are living this reality in Puerto Rico are not just fellow citizens of the world — they are our fellow Americans. Failing them is not only cruel, but unpatriotic. We must do more to help these children get shelter, food, and sanitation and thereby minimize the traumatic effects of these natural disasters.
Cristina Novoa, a policy analyst for Early Childhood Policy at the Center for American Progress, grew up in Puerto Rico.