Almost three weeks since Hurricane Maria made landfall in Puerto Rico, the US island territory is still mired in a massive humanitarian crisis.

Due to the widespread destruction of the island’s power grid and widespread interruption of cell phone and Internet communication, the World Socialist Web Site had been unable to contact readers and supporters in Puerto Rico. However, last week we were able to re-establish contact with Anthony, a student at the University of Puerto Rico.

Anthony lives in a rural area just outside of San Juan, the island’s capital and largest city. In order to reach out to WSWS reporters, Anthony had to travel into the city to find a place with a working Internet connection.

“We have been without power, water and communication services since September 20 [the day Maria hit Puerto Rico],” Anthony emailed. “Only a small percentage of the population has electricity and water. Communications are available only in small parts of the metropolitan area. Things are very slowly starting to normalize, but still we have long lines in banks, gas stations and supermarkets.

“Right now we are lucky because we have several streams near our home that provide us with water, and sometimes the municipal government provides tank trucks with drinking water. Our home was not damaged, but many neighbors lost everything due to the strong winds. It was an extremely strong hurricane, an experience I wouldn’t want to live again.”

Anthony’s experiences are shared by millions of other Puerto Ricans. According to Puerto Rican government statistics, only 11.8 percent of the island’s power grid and 56.9 percent of the water system has been restored. It is a measure of the depth of the crisis on the island that being able to gather water from open streams qualifies Anthony and his family as “lucky.”

Officials estimates are that it will take months to completely restore the power grid, which has been previously devastated by privatization efforts, budget cutting and the mass layoff of linemen and maintenance workers at the publicly owned utility. Ricardo Rosselló, Puerto Rico’s governor, told a press conference on Friday that he expects only 25 percent of the grid to be back up by the end of the month. The destruction of the island’s power infrastructure has produced a rush to purchase generators by those Puerto Ricans who can afford it.

Damage to the San Juan metropolitan area, Anthony continues, “wasn’t as dramatic and disastrous as the towns in the east coast, like Yabucoa and Humacao, which are completely devastated. Also, the towns in the west and center of the island, such as Jayuya, Lares, Utuado, are still isolated and little to no help has arrived there. There are people there who have lost their homes, have no water and no food. Help needs to get to those towns immediately, but the government and army have still done nothing.”

While the official death toll remains at 34 the real number could be far higher. Many of the rural towns have been effectively cut off from the outside world by flooding and landslides, and aid to these communities is only beginning to trickle in.

An article in the Los Angeles Times, “Puerto Rico doctors only now discovering the problems in remote towns,” sheds some light on the scale of the health crisis facing these communities. With only minimal access to health care before the storm, residents in these areas have been stranded for weeks without access to medical assistance, and many are running out of life-saving medications. The roads in the countryside are so damaged, or made impassable by landslides, that volunteer doctors have had to travel to some rural towns by helicopter. “We saw in two days five people die,” one volunteer doctor told the Times .

Dr. Jorge Lopez, another volunteer doctor, also predicted that pools of stagnant water would produce an outbreak of mosquito borne illnesses which would overwhelm the healthcare system in rural areas.

The ongoing health crisis in Puerto Rico could be compounded in the coming weeks and months by the loss of Medicaid benefits by as many as 900,000 of the territory’s 3.4 million people if the US Congress fails to pass additional funding for Puerto Rico’s Medicaid program. The program, which receives half of the proportionate federal funding that the average US state receives, had barely enough funding to last through next year, according to a report by the Hill.

The Trump administration has continued to demonstrate total indifference to the suffering. In an appearance on a Sunday morning talk show, Federal Emergency Management Agency Director Brock Long dismissed further complaints by San Juan Mayor Carmen Yulín Cruz over the Trump administration’s wholly inadequate response by declaring, “We filtered out the mayor a long time ago. We don’t have time for the political noise.”

Long’s rebuke of Cruz, whose comments reflect her nervousness that the government’s criminal negligence is fueling deep social anger, underscores the total contempt of the Trump administration for the victims of the hurricane, a fact that was demonstrated last week by Trump’s perfunctory photo-op in San Juan, where he flicked paper towels into a crowd of Puerto Ricans.

The chief concern of the Trump administration, and the American ruling class as a whole, is to ensure that the hurricane does not affect finance capital’s continued looting of the island, which declared bankruptcy earlier this year. The Financial Times writes that experts expect “the economic damage done by the storm,” which will severely impact tax revenue coming to the territorial government, “to intensify the fight between major bondholders, including hedge funds such as Aurelius Capital and Baupost, and mutual funds such as Franklin Templeton and Oppenheimer over how much each competing class of bondholder should be paid.”

The financial newspaper notes that the damage caused by the hurricane, which was greatly exacerbated by the impact of years of savage austerity to pay the island’s creditors, means that there is no way of knowing how much Puerto Rico could afford to pay on its debt. An offhand remark by Donald Trump last week threatening to restructure Puerto Rico’s debt sent bond markets crashing until the administration made a statement formally disavowing such a course of action.

Puerto Rico was particularly hard hit by the 2008 financial crisis, and since then it has lost approximately 400,000 residents seeking better economic conditions on the mainland. The impact of Hurricane Maria could produce a new wave of mass emigration. A Brookings Institution researcher told the Financial Times that he expects annual migration to double and the island’s population to drop below 3 million “within a few years.”

Elsewhere in the United States, the coastal areas of Louisiana and Mississippi were hit late Saturday night and early Sunday morning by Hurricane Nate, a Category 1 hurricane. Fortunately, the damage from this storm appears to have been limited, and no deaths or injuries were reported, although 38 people had already been killed by the storm in Central America.

The storm had originally been forecast to make landfall near the city of New Orleans as a Category 2 hurricane, but weakened rapidly and shifted east to the less-heavily populated coast of Mississippi. The storm moved rapidly through the area and was over in a matter of hours.

Twelve years after Hurricane Katrina killed 1,800 people and flooded the city of New Orleans, the area remains vulnerable to a direct hit by a major storm. The city’s system of drainage pumps, which it relies upon to push rainwater out of the city that is located below sea level, is barely functional. This was graphically revealed by widespread flooding in mostly low-lying neighborhoods after a series of heavy thunderstorms this summer. Had a larger hurricane passed over the city and produced heavy rainfalls, the city could potentially have experienced serious flooding, even without a catastrophic levee breach like what had occurred in Katrina.