Aid Efforts After Hurricane Maria

by Ana Blanco ’18, Food Institute Student Ambassador

It has been three long months since Hurricane Maria devastated Puerto Rico and we are still in survival mode. I know this all too well. I grew up in San Juan, Puerto Rico and my family continues to live on the island. The emergency relief response has been limited in many areas on the island and although away at school, I decided that one way I could help, was to join Dr. Colon-Ramos of the Milken School of Public Health in an investigation of the nutritional quality of the food delivered.

The work of non-governmental organizations is having a significant impact on the recovery effort. In the food space, World Central Kitchen stands out, having now delivered over 3 million meals to people across Puerto Rico. Chef Jose Andres, who led this effort, was one of my professors in the Sustainable Plate last spring semester. His efforts have been recognized globally, even featured on 60 Minutes.

World Central Kitchen has delivered balanced meals that include fruits, carbohydrates and proteins along with a dairy product. This has been contrasted to the food supplied by FEMA, the Federal Emergency Management Agency, which has received sharp criticism from health professionals concerned with the nutritional value of the food distributed. Photos have gone viral of families in hard to reach areas receiving inadequate food after weeks of waiting for aid. The food, as pictured, includes candy bars, cookies and other snack foods.


Public health professionals at the University of Puerto Rico developed a Mi Plato Huracanado, similar to the original My Plate developed by the USDA that helps individuals have balanced meals on a day-to-day basis.This Mi Plato Huracanado is similar to the original diagram but it now accounts for the foods that have been distributed.

The average MyPlate has the same recommendations regarding servings of vegetables, fruits, grains and proteins except that Mi Plato Huracanado includes only those foods currently available in Puerto Rico. Since over 80% of the island is still without power, a lot of the food available is non-refrigerated and canned. Health professionals continue to be concerned with the nutritional value of food but are equally concerned with the population receiving any food. Since it is now known that many of the foods that have been delivered include candy and highly processed foods, the Mi Plato post-Maria addresses these foods that are high in sugars, saturated fats and sodium.

Tierrney et al. 2013

You may be thinking that any food is better than no food.  And of course, that is correct.  But certain foods can trigger serious, life threatening situations, considering the quality of food aid, even in times of trauma, is critical.  The population of Puerto Rico has a high prevalence of diabetes and obesity. Considering this prevalence, the GW team, led by Dr. Colon-Ramos, began our investigation on what meals are being distributed. We know that Puerto Rico has a high prevalence of diabetes which varies across the island but overall, as shown in Figure 1 (above), nearly 16% of all adults suffer from this disease.  The inadequate meals that have been delivered by FEMA can exacerbate obesity and diabetes levels and cause negative health effects in the long term.

There are high direct and indirect costs associated with diabetes that should be considered. Direct costs include hospitalizations and medicines (such as insulin) but indirect costs include productivity losses and even mortality. Preventing diabetes and obesity in the population is the purpose of the Mi Plato Hurancanado and preventing malnutrition and obesity continues to be a priority for health professionals. To date, our investigation indicates that FEMA is not distributing balanced meals and is failing to reach certain areas which can put a strain on the health sector in the future.


Candy and snacks are not adequate forms of relief. The relief effort in Puerto Rico is just another example of how Puerto Ricans are treated as second class citizens in the United States. We need to improve the nutritional value of the relief effort or it will have severe negative impacts on the population today and in the future.