What Yanira Cardona remembers most about the blackout that swept through Puerto Rico after Hurricane Maria hit is all the waiting.

It took Cardona 11 days to find a working phone and a cellular signal to let her mother in Florida know that she was okay. In the weeks following the storm, she woke up at 2 am to get in line for diesel fuel to run the generator at her father’s home in Sabana Grande on the southwest coast of the island. After waiting for 13 hours, she went home empty-handed. She stood in lines that stretched blocks to get cash, since no electricity meant credit card readers weren’t running.

Unreliable power also meant eating canned food as fresh items in the refrigerator spoiled. Getting one bag of ice required waiting for hours each day in line for the one facility in the area that managed to get its freezer running.

But Cardona knew others had it worse. Over the radio, she heard hospitals plead for diesel fuel to keep vital medical equipment running. She heard elderly callers stranded in the middle of the island beg for help for sick relatives.

Today, on the nine-month anniversary of the storm, there are still thousands of Americans who don’t have electricity in remote parts of Puerto Rico. It’s the largest blackout in US history. It’s the second-largest power outage in the world on record.

It has fueled a housing shortage, a suicide crisis, a spike in the murder rate, and likely more than 4,600 deaths. That a territory that’s home to more Americans than 21 states should suffer with so little for so long is a national disgrace. A hurricane is a force of nature, but a blackout is a human disaster, compounded by failures at every tier of government.

Hurricane season is back, and the power grid still hasn’t returned to status quo ante. In fact, it remains weaker than before, as temporary generators and stopgap repairs hold it together. There have been some efforts to build microgrids, localized electrical networks that bypass the main grid, but the power recovery effort has been marred by missteps like hiring overpriced contractors.

The result is that Puerto Rico’s grid, and its people, may be even more vulnerable to storms than they were a year ago.

The power failure fueled a humanitarian disaster

Puerto Rico’s electrical woes go back years. Financial constraints and bad planning made the island’s power utility notorious for providing high-cost, low-reliability electricity. Even Hurricane Maria wasn’t the start of the blackout.

Another hurricane, Irma, swept through Puerto Rico on September 6 with 185 mph winds. That storm knocked out power for 1 million people with just a glancing blow to the island.

It was an early sign of Puerto Rico’s decrepit power grid and its vulnerability to extreme weather, and was an omen of the darkness to come.

Once the island was mired in darkness that endured for months, Puerto Ricans, who are used to an American standard of living, suffered a major regression in their quality of life.

No electricity meant that water pumps and sewage systems couldn’t function. Taps wouldn’t work, so people turned to natural sources of water. In some parts of Puerto Rico, rivers and streams became contaminated. In one instance, people were drawing water from a well near a hazardous waste site. Some people fell ill as they drank water tainted by rotting horse and cattle carcasses. There were at least 74 suspected cases of leptospirosis, a bacterial infection spread through the urine of infected animals.

“I’ve never seen anything like it, and I’ve worked in disaster response since the ’80s,” said Martha Thompson, the Puerto Rico program manager at Oxfam.

Like the power grid, Puerto Rico’s water infrastructure has suffered from poor maintenance. Puerto Rico had the worst rate of drinking water quality violations of any state or territory in the United States even before Maria. The lack of power stressed an already dangerous water system.

And without electricity, people couldn’t operate medical devices like dialysis machines or refrigerate critical medicines such as insulin. Losing services like air conditioning can exacerbate risks like heart attacks when temperatures rise. But all these things are difficult to track absent electronic medical records and communications systems.

Relief workers saw from the outset that the loss of power was going to make everything worse.

“Immediately, we’re seeing all of these things that are going to become issues if they’re not dealt with. Black mold. Trees down. Twisted metal poles that looked like they were snapped like toys,” said Amy Tidd, a registered nurse who went to Puerto Rico with Nation Nurses United in October 2017. “It was fairly predictable that this would happen, that there would be thousands of deaths if someone didn’t step in and manage the crisis. And what we kept on seeing was a lack of management.”

On Tuesday, the Puerto Rican government began releasing more information on deaths since Maria in response to a court order. The official death toll is 64, but researchers reported recently that the death toll from the storm is more than 4,600. Many of these deaths stem from the lack of power across the island, according to a study in the New England Journal of Medicine:

The most frequently reported problems were an inability to access medications (14.4% of households) and the need for respiratory equipment requiring electricity (9.5%), but many households also reported problems with closed medical facilities (8.6%) or absent doctors (6.1%). In the most remote category, 8.8% of households reported that they had been unable to reach 911 services by telephone.

This makes Hurricane Maria more than twice as deadly as Hurricane Katrina. Thousands more were injured, sick, or homeless due to the storm, and there are still more than 6,000 utility customers that don’t have electricity. Remember that “customer” effectively means a power meter, and each meter can represent multiple people living in a household.

RESUMEN del 11-6-18 (pm) - Contamos con 1342 trabajadores en las líneas de distribución y 359 en las de transmisión. Tenemos el 99.53% (1,466,017) clientes con servicio; continuamos para restablecer el .47% (6,983) restante. CC6 #hastallegar100 pic.twitter.com/mQlniIyWUy — AEE (@AEEONLINE) June 12, 2018

The patchwork of power that slowly came back online provided only intermittent cell, radio, and internet coverage, allowing misinformation to spread about what relief options were available to people and obscuring the full scope of the storm’s destruction.

“I didn’t learn the extent of the damages until I came [to Florida] a month after the hurricane,” Cardona said.

Puerto Rico’s power outage didn’t have to last so long

It’s striking to compare the pace of the power restoration after Maria to other outages from the other major 2017 hurricanes to make landfall in the United States.

Hurricane Harvey knocked out power to 336,000 customers on the Texas coast, and Hurricane Irma disrupted electricity for more than 4 million customers in the Southeast, but power was fully restored to both regions in a matter of weeks after the storms.

In Puerto Rico however, the island’s public utility, its local government, and the federal government didn’t do enough to prepare, were slow to respond, and made critical mistakes along the way.

Part of the reason it’s taken so long to restore power in Puerto Rico is that it’s an island. There’s always an added cost and more time required to bring in power poles and generators over water compared to bringing supplies to areas on the mainland. Regulations like the Jones Act, which only allows US ships to carry goods between US ports, further bottlenecked the supply chain.

The Puerto Rican government and its electric power utility, the Puerto Rico Electric Power Authority (PREPA), were also in dire financial straits before the storm. The transmission network was outdated and poorly maintained, and PREPA had a hard time retaining skilled workers who understood Puerto Rico’s grid. Nepotism and high turnover plagued PREPA’s management.

In addition, the grid itself was fragile. Half of Puerto Rico’s generators run on imported diesel, and most power plants are on its southern coast. The main power consumers, however, are on the north side of the island, forcing the utility to route power 40 miles over Puerto Rico’s mountainous center. This created narrow, difficult-to-repair choke points in the power grid.

Ahead of Maria’s landfall, PREPA declined to invoke mutual aid agreements with other public utilities, as electric companies in Florida did ahead of Irma. The reason PREPA officials gave was they weren’t sure they could afford the upfront payments needed to have line workers on hand.

Instead, PREPA opted to sign piecemeal agreements with private repair crews, including a $300 million contract with a tiny, inexperienced contractor called Whitefish Energy. The company charged more than double the going rate for workers and higher-than-normal rates for meals. PREPA later canceled the arrangement after the deal drew scrutiny, but Congress and the FBI are both investigating.

Standing ovation for the line-workers who helped to restore power in Puerto Rico in the wake of #HurricaneMaria #EEI2018 pic.twitter.com/iSpA6ExBOQ — Julia Pyper (@JMPyper) June 5, 2018

The federal government was also slow to act. PBS Frontline noted that there were 30,000 federal workers deployed to afflicted regions nine days after Hurricane Harvey, 22,000 sent to areas hit by Irma, and just 10,000 sent to deal with the aftermath of Hurricane Maria.

Each storm stretched the Federal Emergency Management Agency’s resources thinner. FEMA went back and forth over how long it was going to remain involved in Puerto Rico’s recovery effort. Residents were alarmed to hear that FEMA was stopping food and water shipments in January. Some members of Congress were outraged that the agency was planning to end its mission before power was fully restored.

Puerto Rico's blackout is now the largest in American history, with more than 20,000 still without power.



Sen. @MartinHeinrich doesn't think that means "mission accomplished." pic.twitter.com/nySLKOx3lG — Vox (@voxdotcom) May 8, 2018

President Trump did sign a $16 billion federal aid package into law for Puerto Rico, but it wasn’t until February and it’s only a fraction of the $94.4 billion Puerto Rico Gov. Ricardo Rosselló said the island needs to recover from the storm. Congress has approved close to $30 billion to date for Puerto Rico.

Puerto Rico missed an opportunity to rebuild stronger

The utter destruction of Puerto Rico’s power grid created a blank slate to rebuild in a more thoughtful way. It was an opportunity to distribute power generators across the island, build more robust transmission lines, add in some redundancy, and switch to energy sources that don’t have to be imported.

This happened at small scales. Companies like Tesla and Sunrun provided solar power and storage systems, helping critical buildings like hospitals and fire stations power up independent of the main electric grid.

But with so many people without power, relief workers were often simply trying to restore the grid as quickly as possible, which meant using temporary hardware that may not stand up to another storm. Some towns in Puerto Rico grew frustrated with the wait and began erecting their own utility poles and stringing transmission lines by hand. This amateur electrical work could easily fail in another disaster.

Much of the island is still running on hundreds of temporary generators backed by the US Army Corps of Engineers. This includes large generators to stabilize the grid as well as hundreds of smaller units to power “850 critical facilities and infrastructure.”

Thompson said the rebuilding effort was an “enormous” missed opportunity. “This was a deteriorated system. It was in bad shape, and it was built back [at best] to the state that it was in,” she said.

That’s due in part to federal regulations like the Stafford Act, which limit emergency funds to restoring the grid as it was before the storm rather than making much needed long-term improvements.

“The Stafford Act does not contemplate, as it’s written, rebuilding an electric system,” said Bruce Walker, the assistant secretary for electricity delivery and energy reliability at the Department of Energy, at a House hearing in April. “By virtue of the way the Stafford Act is written, it contemplates things being put back the way that they were.”

Now the grid in an even more delicate state, and PREPA is in the process of being privatized. Even Puerto Ricans who had their power restored have experienced multiple subsequent blackouts. In April, a bulldozer hit a power line, which knocked out electricity for the entire island.

This year’s hurricane season doesn’t appear to be especially strong or weak, but another hit from a storm could blow down power lines and sever temporary grid connections, rolling back hard-fought progress.

“I don’t think we are ready for another hurricane,” said Ruth Santiago, an attorney in Puerto Rico working on environmental issues, of the power grid. “I think the problem is we’re seeing lip service from the government and not a lot of action.”

For her part, Yanira Cardona is heading back to Puerto Rico this week geared up to face another hurricane.

“I have a whole bunch of battery D’s [D cells]. I already have flashlights. I have bottles of water. I have cans of food already saved up. I even have cash I save up monthly and hide it,” she said. “I told my father to start saving diesel. At least my family in Puerto Rico, they’re getting prepared already.”