

Neighbors sit on a couch outside their destroyed homes as sun sets in Yabucoa, Puerto Rico, on Sept. 26 — about a week after Hurricane Maria hit. (Gerald Herbert/AP)

Late each night, Rafael Surillo Ruiz, the mayor of a town with one of Puerto Rico's most critical ports, drives for miles on darkened roads, easing around downed power lines and crumpled tree branches — to check his email.

At the wheel of his "guagua"— local slang for an SUV — he sometimes finds a spotty cellphone signal on a highway overpass, and there he sits, often for hours, scrolling through messages. During the day, with no working landline and no Internet access, he operates more like a 19th-century mayor of Yabucoa, orchestrating the city's business in an information vacuum, dispatching notes scrawled on slips of paper — about problems such as balky generators and misdirected water deliveries — that he hands to runners.

On the other side of the mayor's favorite overpass spot, one of the generators at the area's biggest hospital has collapsed from exhaustion, and the frazzled staff have stopped admitting new patients. Deeper into the island's mountainous interior, thirsty Puerto Ricans draw drinking water from the mud-caked crevices of roadside rock formations and bathe in creeks too small to have names.

"We feel completely abandoned here," ­Surillo Ruiz said with a heavy sigh.

[A light amid the darkness, a Puerto Rico church stands up as its community struggles]

It has been three weeks since Hurricane Maria savaged Puerto Rico, and life in the capital city of San Juan inches toward something that remotely resembles a new, uncomfortable form of normalcy. Families once again loll on the shaded steps of the Mercado de Santurce traditional market on a Sunday afternoon, and a smattering of restaurants and stores open their doors along sidewalks still thick with debris and tangled power lines.

But much of the rest of the island lies in the chokehold of a turgid, frustrating and perilous slog toward recovery.



Cars pass through a damaged area in Yabucoa, Puerto Rico, on Sept. 29. (Hector Retamal/AFP/Getty Images)

When night comes, the vast majority of this 100-mile long, 35-mile wide island plunges into profound darkness, exposing the impotence of a long-troubled power grid that was tattered by Maria's winds and rains. Eighty-four percent of the island is still without power, according to the governor's office, and local officials in many areas are steeling themselves — with a sense of anger and dread — for six months or more without electricity.

Roughly half of Puerto Ricans have no working cellphone service, creating islands of isolation within the island and cutting off hundreds of thousands of people in regions outside the largest metropolitan areas from regular contact with their families, aid groups, medical care and the central government. Christine Enid Nieves Rodriguez, who has set up a community kitchen near the southeastern city of Humacao, has dubbed the new reality Puerto Rico's "dystopian future."



The jumbled contents of a store lie exposed to the elements where a roof was torn away at the Palma Real Shopping Center in Humacao, as seen Sept. 22, two days after Hurricane Maria devastated large areas of Puerto Rico. (DENNIS M. RIVERA PICHARDO/For The Washington Post)

Accompanying that vision of the future are worries about outbreaks of diseases such as scabies and Zika, which is transmitted by mosquitoes breeding in standing water. Just 63 percent of the island's residents have access to clean drinking water, and only 60 percent of wastewater treatment plants are operating, according to figures released by the Federal Emergency Management Agency.

In poorer communities, such as the San Juan neighborhood of Carolina and the mountain town of Canovanas, doctors are seeing worrying numbers of patients with conjunctivitis and gastritis brought on by contaminated water and poor hygiene.

With electrical and cellphone outages complicating commerce, large swaths of the island — and even many spots within the biggest cities — are cash-only zones, as if credit cards never existed. More than 40 percent of bank branches have yet to reopen, according to the governor's office, and barely more than 560 ATMs are functioning for an island with a population of more than 3.4 million.

On the upside, chronic gasoline shortages that plagued the early days after the storm seem to be easing, at least in the larger cities, and 86 percent of grocery stores have reopened. But the journey to fill the gas tank or the shopping cart can be an exercise in faith and blind courage. In the sprawling metropolis of San Juan, crisscrossed by major highways and multilane streets, most streetlights are not functioning. Only a surge of post-hurricane politeness and patience seems to be preventing the morgues from swelling with traffic fatalities.

The roads in and out of San Juan are lined by denuded hillsides, their rocky, frayed surfaces exposed to the sunlight. The storm acted like a blowtorch, searing off leaves and stripping away topsoil. A surreal consequence of Maria's transformation of the island's landscape is the lack of shade in once-divine town squares and jungle-like hinterlands.

It is enough to make many Puerto Ricans consider fleeing the island for good, even though the thought of leaving a place they love can still seem implausible. What awaits many of them here is protracted subsistence living. In places such as the surfer haven of Playa Jobos on the northwestern coast, a woman whose wooden house was blown to bits has taken to living in a disabled food truck outfitted with a hammock.

"When I think about grandchildren, I know that I don't want this for them," said Lucy Rivera, an unemployed single mother who has crammed nine people, including her disabled mother and mentally ill brother, into a house that lost its roof in the town of Canovanas near El Yunque National Forest.

Rivera has no money, and her government assistance card is useless in the many businesses that have gone cash-only. So she sits in traffic for hours in a borrowed car trying to find food and get medical care.

On a recent afternoon on one of those choked Puerto Rican roads, cars jammed with children and plastic jugs pulled over to gaze at the ingenuity of Jesus Sanchez, a wiry 74-year-old retiree. Sanchez had fished a six-foot length of PVC pipe out of a ditch in Toa Alta, an ancient town 17 miles outside San Juan. He had lashed it to a forked branch with some shredded cloth and inserted the mouth of the pipe into a crook that began gushing water in the steep limestone hillside above his head.

"Now!" he called to his wife, Ana Marrero Nieves.

Marrero Nieves proceeded to toss plastic jugs — empty containers that once held cranberry juice and canola oil — over to Sanchez, who clung to the muddy slope, slipping and sliding, but smiling. More than 2½ weeks had passed since the storm, and he had not received any aid at their house, where the windows were blown out. But, from the hillside, he drew sustenance, just as he had done for days.

"If it wasn't for this, how many would have died?" he said.



Ruth Santiago refreshes herself with water from a pipe in Morovis, Puerto Rico, on Oct. 4. Hurricane Maria destroyed the town's bridge. (Alvin Baez/Reuters)

The roads narrow as they snake up the mountains, then dip down into the jaw-dropping valleys of central Puerto Rico, passing by town after town where the wind tore roofs off nearly every humble cinder-block dwelling and splintered the yet-humbler wooden shacks. Flamboyant trees that once prettied the countryside with branches lit by brilliant red flowers lie by the thousands alongside thick-trunked rubber trees. Stands of bamboo with stalks thicker than the fat end of a baseball bat form archways that scrape the roofs of all but the squattest of cars.

Being miles away from the coast provided no safety to the residents of Morovis, a town of about 30,000 that sprawls over bluffs and into ravines in north-central Puerto Rico. Zerimar Rivera, a 31-year-old mother of twin boys, couldn't stand the smell of sweat anymore and headed for a trickling creek south of town.

"We're going to the washboard, like in the time of our grandparents," she called out to a friend, as she plunged a shirt into a five-

gallon paint primer bucket filled with creek water and detergent. Rivera is a teacher, and like many middle- and lower-middle-class Puerto Ricans, she is paid only when she works, and she has not worked a moment since the storm hit on Sept. 20.



Rafael Reyes, his wife, Xarelis Negron, and their son, Xariel, stand next to salvaged belongings wrapped in plastic on the foundation of their shattered home in the San Lorenzo neighborhood of Morovis, Puerto Rico, on Oct. 7. (Ramon Espinosa/AP)

Rivera's dilemma is the same as that facing Eric Bonet and Sherrie Berrios, a couple who work as dog groomers in the town of Barceloneta. One day after the storm, Berrios says, they were hungry and thirsty when Bonet turned to her and said, "I think I'm going to turn the car into a pickup truck."

Bonet quickly stripped the seats out of the back of their 1994 Nissan Altima. He enlisted a buddy to join them and stuffed some couch cushions in the back so Berrios would have a place to sit, and they were off in search of aluminum.

In Morovis, they scored big-time, rifling through a pile of garbage across from an outdoor bar until they found an old-

fashioned restaurant sign with an aluminum frame. Bonet ripped it off with an eight-inch Ginsu kitchen knife and added the loot to the rest of the treasures they had strapped to the car's roof. Days of work earned them $140 at 30 cents a pound.

[There was once a bridge here: A devastated Puerto Rico community deals with isolation after Maria]

There is almost no place on the island where the enterprising scavenger couple couldn't stand a decent chance of adding to their pile. The storm was so brutal and so wide that it covered the length and breadth of the island, damaging at least 60,000 homes, according to government estimates that some here consider far below the real figure. But only one place can claim to be the spot where Maria made landfall, and that is down along the southeastern coast near Yabucoa, where Surillo Ruiz is mayor.

Yabucoa sits in a wide, fertile valley, which is perfect for growing plantains but is also an ideal funnel for hurricane winds. On an incline overlooking the valley, Carmen Manso presides at a senior center that doubles as a local museum inside a grand, century-old house with wide wooden beams and tile floors that resemble a checkerboard. Her handful of clients, including several who served in the U.S. military, stick to the lower floor because the storm tore off much of the building's roof, exposing upstairs rooms filled with paintings, artifacts and beds.

"When it rains, this is like Niagara Falls," Manso said with a chuckle. She does not have much choice but to laugh. One morning she set off with several of her clients' ATM cards so she could withdraw money for them.

She drove 25 minutes to the town of Humacao, but the bank was closed.

She drove another half-hour to the town of Gurabo, but they had run out of money.

She pressed on another 20 minutes down the road and arrived at a bank in Caguas. The line at the ATM trailed down the street; 2½ hours later, she finally was able to pull out some cash for her clients. And she still had to drive home.



Motorists wait in line to buy gasoline in the aftermath of Hurricane Maria, in Morovis, Puerto Rico. (Gerald Herbert/AP)

She returned to a place where the mayor had been run out of city hall by storm winds that punched a massive, jagged hole in the roof, turning the building into an outsize, end-to-end pass-through window. The mayor is now based in a small conference room in his town's medical clinic. He got a satellite phone as government recovery aid, but he can't make it work — a complaint other mayors with similar technology have echoed.

On his nightly trip in search of a cellphone signal, Surillo Ruiz keeps hearing from people on the U.S. mainland who want to help his town. One night it was Ricky Martin, the heartthrob Puerto Rican singer whose charitable foundation has been active in the relief effort. But Surillo Ruiz really does not know how to respond to most requests. He has little faith, he says, that aid intended for Yabucoa will make it to Yabucoa. He worries that it will either be misappropriated because of corruption or mishandled through incompetence or confusion.

He worries even more about the potential for a health crisis. The nearest full-scale medical center — Ryder Memorial Hospital, a 103-year-old nonprofit institution — is 13 hard-driving miles away. The hospital, too, is cut off from the world.

"When people say send me an email, I say, 'What! By smoke signals?' " said Deana Hallman, Ryder's medical director.

[Puerto Rico’s humanitarian crisis nowhere more obvious than at hospitals]

Hallman and other hospital executives were unstinting in their criticism of Puerto Rico's health secretary, Rafael Rodriguez-Mercado, accusing him of wasting time "assigning blame" to others and sowing "divisiveness." Health Department officials have not responded to requests for comment.

One of Ryder's generators failed a few days ago, and several critically ill patients had to be flown to a U.S. Navy hospital ship. By last weekend, the other generators, which according to the hospital's protocols are not supposed to run for more than seven days, had been operating for 17.

By chance, Hallman was passing through an area with cell coverage a few days ago, and she lurched her car to a stop. An administrator at another hospital told her about a meeting with government health officials in San Juan, a gathering that was supposed to be an opportunity for the government to tell hospitals what it could do to help them.

Each hospital got a sheet listing the aid it would receive following government assessments of their needs.

Some of the lists were long. Ryder's was short.

It had just one item: diesel.

There was only one problem: Ryder had not asked for diesel, Hallman said. It had plenty.

Instead, the hospital had been asking — over and over, through 10 site visits by Puerto Rican and federal officials — for repairs to the electrical grid that would end their reliance on generators.

"The government just needs to put the grid back," Lirio Torres Sepulveda, a Ryder executive said. "That's their job."