Puerto Ricans sharply rebuke President Trump, along with the federal and local governments, for last year’s response to Hurricane Maria, a devastating storm that created an enduring humanitarian crisis affecting nearly all aspects of life on the island territory, according to a new Washington Post-Kaiser Family Foundation poll.

About this series The Washington Post and Kaiser Family Foundation conducted a face-to-face survey of 1,500 randomly selected adult residents in Puerto Rico from July 3 to Aug. 29, 2018, all of whom lived in the U.S. territory when Hurricane Maria hit in September 2017. The margin of sampling error for overall results is plus or minus 3.5 percentage points. Read why and how the survey was conducted.

Nearly a year after Maria hit Puerto Rico, people say they are still struggling with basic necessities. Fully 83 percent reported either major damage to their homes, losing power for more than three months, employment setbacks or worsening health problems, among other effects of the storm. The power is spotty, and many are leery of drinking the water. Roads are damaged, dangerous and difficult to navigate — like “the surface of the moon,” according to one resident — and in some places, the roadways remain impassible.

“We’re living day by day, and we’re living with hope that things might get better, but they have not,” said Jorge Antonio Rodriguez Zayas, a 55-year-old diabetes educator from Bayamon. He thinks the federal response was disorganized and gives low marks to Trump.

Washington Post-Kaiser Family Foundation Poll POLL Puerto Ricans give negative ratings to Trump, federal government and local government for Hurricane Maria response Q: How would you rate the job each has done in responding to Hurricane Maria? President Trump Excellent/Very Good/Good 15% Fair/Poor 80 52 Poor The Puerto Rican government Excellent/Very Good/Good 25 Fair or poor 34 74 Gov. Ricardo Rosselló Excellent/Very Good/Good 31 Fair or poor 67 31 The federal government Excellent/Very Good/Good 39 Fair or poor 22 58 Your municipal government Excellent/Very Good/Good 41 Fair or poor 33 58 Note: No opinion not shown Source: July 3 to Aug. 29, 2018, Washington Post-Kaiser Family Foundation poll of 1,500 Puerto Rico residents with an error margin of +/- 3.5 percentage points. POLL Washington Post-Kaiser Family Foundation Poll Puerto Ricans give negative ratings to Trump, federal government and local government for Hurricane Maria response Q: How would you rate the job each has done in responding to Hurricane Maria? President Trump Excellent/Very Good/Good 15% Fair/Poor 52 80 Poor The Puerto Rican government Excellent/Very Good/Good 25 Fair/Poor 34 74 Gov. Ricardo Rosselló Excellent/Very Good/Good 31 Fair/Poor 31 67 Excellent/Very Good/Good 39 The federal government Fair/Poor 58 22 Your municipal government Excellent/Very Good/Good 41 Fair/Poor 33 58 Note: No opinion not shown Source: July 3 to Aug. 29, 2018, Washington Post-Kaiser Family Foundation poll of 1,500 Puerto Rico residents with an error margin of +/- 3.5 percentage points.

Trump has long maintained that his administration’s recovery effort in Puerto Rico was appropriate and effective, saying the federal government did “a fantastic job” there. He reiterated that point Tuesday, in remarks in the Oval Office, when he called the response to the hurricane in the U.S. territory “an incredible, unsung success.” On Wednesday morning, touting the government’s preparation for the impending landfall of Hurricane Florence along the East Coast this week, Trump tweeted that his administration “did an unappreciated great job in Puerto Rico.”

“It’s amazing that he really believes that,” Zayas said of Trump’s consistent position on the Puerto Rico recovery effort.

Puerto Ricans say the lackluster response to the hurricane, which ravaged the island in September 2017, was due to a failure of government at all levels, from the president down to municipal authorities. Eighty percent of Puerto Ricans rate Trump’s response to Maria negatively, an assessment that contradicts the president’s claim two weeks ago that “most of the people in Puerto Rico appreciate what we’ve done.”

In Adjuntas, Puerto Rico, a mural bears the number 4,645 the number of deaths found by a Harvard University study in May to be linked to Hurricane Maria. The number became a sign of protest after the Puerto Rican government maintained that only 64 people died in the storm. The government now has the official death toll at 2,975, a number determined in a George Washington University study published in August.

More than 7 in 10 residents give negative marks to the Puerto Rican government’s efforts, while two-thirds criticize the response of Puerto Rico Gov. Ricardo Rosselló. Smaller majorities are critical of the response from both the federal government and municipal authorities.

Beyond disappointment, most Puerto Ricans see the federal government as apathetic about helping the U.S. territory recover. A 55 percent majority believes rebuilding Puerto Rico is not a priority for the U.S. government, and roughly 6 in 10 say the federal response to Maria was worse because of the island’s lack of statehood.

“The president of the United States has to remember that we’re Puerto Ricans; if you like it or not, we’re part of the United States, too,” said Ramon Pachaco, 58, who lives in Ponce, a city on the island’s southern coast. “You see the response they got in Miami and New Orleans; they respond right away. Over here, it ain’t working that way. It’s rough.”

Washington Post-Kaiser Family Foundation Poll POLL The wide-ranging impact of Maria on Puerto Ricans Percentage of Puerto Rico residents who/whose… Experienced any of the followingdue to Hurricane Maria 83% Had a power outage of more than 3 months 44 Experienced negative income or employment effects 42 Home was destroyed or had major damage 26 Had a new or worsened health condition* 23 Drank water from a natural source 21 Vehicle was damaged 21 Received mental-health services* 9 *They or a household member Source: July 3 to Aug. 29, 2018, Washington Post-Kaiser Family Foundation poll of 1,500 Puerto Rico residents with an error margin of +/- 3.5 percentage points. POLL Washington Post-Kaiser Family Foundation Poll The wide-ranging impact of Maria on Puerto Ricans Percentage of Puerto Rico residents who/whose… Experienced any of the following due to Hurricane Maria 83% Had a power outage of more than 3 months 44 Experienced negative income or employment effects 42 Home was destroyed or had major damage 26 Had a new or worsened health condition* 23 Drank water from a natural source 21 Vehicle was damaged 21 Received mental-health services* 9 *They or a household member Source: July 3 to Aug. 29, 2018, Washington Post-Kaiser Family Foundation poll of 1,500 Puerto Rico residents with an error margin of +/- 3.5 percentage points.

The Post-Kaiser survey, conducted face to face among 1,500 randomly selected Puerto Ricans in July and August, is the first to gauge residents’ experiences during and after Maria’s landfall and their views of recovery efforts. The survey finds that the storm had an extraordinary impact across the island, with significant problems persisting nearly one year later:

• Two-thirds say the storm caused major or minor damage to their homes, and most of them say the structures have not been restored to their original condition.

• Ninety-three percent say their areas need more resources to repair roads and highways.

• Fifty percent say people in their households could not get enough water to drink, and 53 percent say they are still worried about the quality of water in their homes.

• More than 4 in 10 Puerto Ricans say their power was not restored until January or later — four months after the storm — and while nearly all residents now have access to working grid power, outages are common. More than 3 in 4 say they lost power for at least one hour in the previous month.

• Since Maria hit, 24 percent say their households borrowed money from friends or relatives to make ends meet, 26 percent had problems paying for food, 17 percent fell behind in paying their rent or mortgage, and 22 percent took on an extra job or worked extra hours to make ends meet.

Deaths due to the storm and its aftermath have long been a contentious issue; the Puerto Rican government for months maintained that 64 people died in the hurricane, despite evidence of a far greater death toll. A study published in August by George Washington University said there was a spike in mortality across Puerto Rico in the six months after the storm, with an estimated 2,975 excess deaths attributed to the hurricane and its aftermath. Most of those deaths occurred more than a month after the storm hit. Puerto Rico’s government has adopted that number as the official death toll.

Survey findings support the widespread nature of deaths related to the storm, with about 1 in 5 Puerto Rico residents saying a close friend or family member died either from injuries caused by the storm or because they were unable to get sufficient water, food or medical care in the months afterward.

The Post-Kaiser poll confirms anecdotal reports of people fleeing Puerto Rico after the storm, with 68 percent of island residents saying they know a close friend or family member who has moved away from the island since Maria. Overall, about 1 in 4 of those who remain are seriously considering also moving away.

[Sin Luz: Life without power]

Most Puerto Ricans were not surprised by Maria’s arrival, with nearly three-quarters saying residents got enough warning about its severity before it hit. But the storm’s path through the middle of the island exerted extraordinary damage from coast to coast. Almost 100 percent of residents lost power afterward, according to the Post-Kaiser survey. The prolonged lack of electricity and extraordinarily broad impact across the island seemed to complicate the recovery efforts.

The most prevalent problem arising from the power loss was difficulty storing food. But the lack of electricity also severely affected those who are chronically ill and depend on power to keep medications at the correct temperature or to operate vital medical equipment.

About a quarter of residents say power loss from Maria affected their ability to store medication and use medical devices, and 17 percent say they or a member of their family needed mental-health services after the storm but did not receive them.

“Not only did Maria affect their homes and electricity, which is necessary to keep their insulin at the right temperature, the supplies disappeared,” said Zayas, who worked around the clock after the storm to help those with diabetes. “The pharmacies were not open, the doctors were not available, the hospitals had no electricity . . . that became a nightmare. Many of them suffered complications due to the lack of medications.”

The storm also made it extremely difficult for many on the island to access drinking water; about 1 in 5 drank water from a natural source after the storm.

Pachaco said he went to a nearby mountain to draw drinking water from a spring for about four months after Maria hit.

“It was rough,” he said. Now, he refuses to drink the tap water. “It tastes like mud. If you drink it, you feel like your mouth is filled with dirt.”

The storm’s impact was stark across the island, with at least 3 in 4 residents in each region reporting major home damage, vehicle damage, extended power outages, job or income loss, a household member’s health worsening, or drinking water from natural sources. The storm’s aftermath was felt personally by roughly 9 in 10 residents of regions in the eastern and northern parts of the island, which took the brunt of the storm.

Ruth Santiago, 66, of Toa Baja in the north, said that her house sustained damage and that all the trees around her house fell, destroying her fence. Water still comes through her ceiling, and there is fungus. Santiago said she applied for help from the federal and local governments but did not receive any, so she turned to her church for help.

“I got tired of waiting,” she said.

Getting around the island is far more difficult than before the storm. The Post-Kaiser survey finds residents almost unanimously say that their area needs more help repairing roads and highways. They include Lidio Ronda Pagan, a 69-year-old from San Juan who thinks that road conditions are the biggest problem since the storm. Thoroughfares are patched up constantly, he said, but not properly.

“Here they make a repair, and you go by there, and it feels like you’re on the surface of the moon,” he said. “It’s really bad.”

The moon rises over mountains in Adjuntas, Puerto Rico.

Pagan gave high marks to the Federal Emergency Management Agency, saying its response was “quick and good” and noting that it had to deal with the geography of the island, which is far from the U.S. mainland, thick with vegetation and cut by mountains. Roughly 1 in 4 Puerto Ricans say they were approved for assistance from FEMA; of them, 71 percent were satisfied with the help they received. About 1 in 4 say they applied for and were denied FEMA funding, while 4 percent say their applications are pending. Separately, 23 percent say their families received help paying for food, housing or health care or got other financial aid from nonprofits or charities, such as churches. Despite the numerous challenges, though, 65 percent of Puerto Ricans say their overall quality of life is about the same as before Maria hit.

[Failure of imagination hindered federal Puerto Rico response amid rough hurricane season]

But there was little satisfaction with other parts of government, from leaders on the island to Washington, D.C. Nearly 6 in 10 say the U.S. government did a “fair” or “poor” job responding to Maria, and a similar share gave negative marks to their municipal government and mayor. Negative ratings rise to 67 percent for Rosselló, the governor, and to 74 percent for the Puerto Rican government as a whole.

Puerto Ricans’ most intense ire is reserved for Trump. Eight in 10 rate Trump’s response negatively, including roughly half of residents who give him the lowest grade of “poor.” About a third or fewer residents say the same about Rosselló, the federal government or local governments.

Washington Post-Kaiser Family Foundation Poll POLL A majority of Puerto Ricans are concerned about the future Percentage of Puerto Rico residents who say… They are worried another hurricane will cause similar/worse damage 91% They are preparing for future hurricanes 81 Puerto Ricans are not prepared for future hurricanes 67 The federal government is not prepared for future hurricanes 54 They are seriously considering moving from Puerto Rico 27 Source: July 3 to Aug. 29, 2018, Washington Post-Kaiser Family Foundation poll of 1,500 Puerto Rico residents with an error margin of +/- 3.5 percentage points. POLL Washington Post-Kaiser Family Foundation Poll A majority of Puerto Ricans are concerned about the future Percentage of Puerto Rico residents who say… They are worried another hurricane will cause similar/worse damage 91% They are preparing for future hurricanes 81 Puerto Ricans are not prepared for future hurricanes 67 The federal government is not prepared for future hurricanes 54 They are seriously considering moving from Puerto Rico 27 Source: July 3 to Aug. 29, 2018, Washington Post-Kaiser Family Foundation poll of 1,500 Puerto Rico residents with an error margin of +/- 3.5 percentage points.

In follow-up interviews, some said they believed the president initially did a good job but then neglected the recovery. Others said they have been dissatisfied with Trump since the storm hit and became angrier after the president visited the island in October.

“I believe he should have never come,” said Angel Molina, a retired Army colonel from Bayamon. “There was a scene that was very inappropriate for the president, when he started throwing paper towels to the audience; that was very inappropriate for the president. It don’t bring any help. I considered that an insult to us, for our president to come here and start throwing paper towels to an audience.”

A clear majority of Puerto Ricans believe the federal response to Maria would have been better if Puerto Rico were a state, and slightly more than half say the federal response to Maria was worse than that to Hurricane Harvey in Texas.

Respondents say Puerto Rico’s government didn’t do much better.

“They ignored the situation, yes. Not totally the federal government, but the Puerto Rican government,” said Raylit Alfanso, a 25-year-old from San Juan. He said the local government doesn’t clear storm drains, among other things, contributing to flooding problems.

“If they do their job, their regular job that they have to do, they can stop some issues in the future,” he said.

While the poll finds that Puerto Ricans feel U.S. leaders have not prioritized the recovery, a separate Kaiser Family Foundation survey of Americans overall finds that 73 percent say rebuilding the island should be a priority for the federal government, including majorities of Democrats, Republicans and independents. U.S. residents beyond Puerto Rico overwhelmingly perceive that life in Puerto Rico is still disrupted, and more than 6 in 10 think the recovery would have been better if the territory were a state.

Among Puerto Ricans, the lack of what most see as an adequate response is worrisome and has caused them to fear another storm of any type. While roughly 8 in 10 in the Post-Kaiser survey say they and their families have taken steps to prepare for future hurricanes, more than three-quarters also say they are very worried that another hurricane will hit Puerto Rico and cause similar or worse damage. There is concern about whether authorities would be able to help should a storm hit; 54 percent say the federal government is not prepared to deal with future hurricanes on the island, and 67 percent say Puerto Ricans are not ready.

“Forget it. We get another storm like Maria, we’re history,” Pachaco said. “It’s going to take years and years to rebuild. We’re still fragile.”