Disaster relief is about more than healing physical trauma. It's about emotional recovery too.

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Image: unicef usa

Disaster relief is most commonly thought of as providing food, water, and shelter to those affected by calamitous events beyond their control. 

But as communities in places like Texas and Puerto Rico are learning, disaster relief that only alleviates physical wants is not enough to put their communities back on their feet.

After first responders have done their jobs to secure personal safety, an emotional recovery has to begin as well. 

Organizations like UNICEF are acknowledging that the damage to communities can last long after the repairs to homes are completed.

Canned goods and other basic need items are given out in a disaster relief station in southeast Texas.

Canned goods and other basic need items are given out in a disaster relief station in southeast Texas.

Image: Getty Images

“When the reality of the disaster sets in, the emotional and psychological responses that are seen community-wide are tremendous and overwhelming,” Center for School Behavioral Health director Janet Pozmantier said. “People simply don’t have the wherewithal to cope effectively.”

That’s where organizations like UNICEF are stepping in. Called psychosocial disaster relief, this kind of help comes in the weeks and months after a disaster in order to help people recover emotionally.

If UNICEF can help it, these recovery efforts will be implemented after every storm. 

Psychosocial relief in the wake of Hurricanes Maria and Harvey are currently ongoing, and UNICEF knows that the aftermath of Hurricane Florence in the Carolinas will also require this kind of help in the near future.

Other organizations like the Red Cross have also been championing psychological first aid measures for years, and with good reason.

Research suggests that those who have survived catastrophe tend to start showing signs of trauma roughly three months after the event took place. Those signs can look like anything from anxiety and depression to constant irritability and anger or even complete dissociation and inattention in both children and adults. 

In order to combat these symptoms, Pozmantier and other staff at the center working under Mental Health America in Greater Houston developed free workshops to teach others how to effectively help people struggling in the aftermath of traumatic disaster-related events. 

Damaged furniture and personal belongings sit on a flooded curb in Southeast Texas.

Damaged furniture and personal belongings sit on a flooded curb in Southeast Texas.

Image: Getty Images

The workshop focuses on helping educators identify signs and symptoms of trauma in children while also including other useful tools like mindfulness training and how to self-regulate emotions. 

After Hurricane Harvey made landfall in Texas, UNICEF reached out to the center and offered to fund a Harvey-specific trauma training workshop, which the center named Hope for Harvey. 

In the months after Harvey made landfall in Texas, Pozmantier would drive through neighborhoods and see the entire contents of homes in a pile on the curb — family photos and clothing laying on top of piles of water damaged furniture — all ready to be collected by waste management. 

She said it was easy to understand why people would be traumatized. 

So when the center developed Hope for Harvey, aside from training people to deal with trauma in children, they also added some training on how to deal with adults. 

“Going through something like this, I realized more than ever that if we can take care of the adults, the kids are going to be okay for the most part too,” Pozmantier said. 

Nine months later, when UNICEF approached the center again to help Puerto Rico recover, the message was the same. 

The center developed a workshop, completely in Spanish, to help curb the emotional impact Hurricane Maria had on the people of Puerto Rico, focusing again on children — but also providing help to adults. 

First, UNICEF sent hygiene kits, water, and helped with shelter. But what UNICEF President Caryl Stern said she’s most proud of is the collaborative work that UNICEF and the Center for School Behavioral Health were able to put into action. 

A man and a child stand in front of a destoryed house in Puerto Rico a few days after Hurricane Maria hit the island.

A man and a child stand in front of a destoryed house in Puerto Rico a few days after Hurricane Maria hit the island.

Image: unicef usa

“Now classrooms are catastrophe stations the every time it rains in Puerto Rico. The children are worried that their home is destroyed. Or they’re wondering ‘Is my mother okay?’” Stern said. 

Even seeing adults in distress can trigger the children, Stern said. 

Once Stern experienced this, she said she know that the training workshops would be incredibly important. 

In addition to the workshops, UNICEF sent a few hundred college students from State University of New York and City University of New York to pair up with member of various Puerto Rican communities to help rebuild the Boys and Girls Clubs of Puerto Rico. 

Through this, people were able to come together and repair their communities themselves — something that can have a strong positive effect on the psyche.  

Stern says everyone who has ever dealt with disaster relief knows that the psychosocial recovery is the most import aspect of relief that is widely ignored by the public. 

Pozmantier agreed, adding that if she could, she would mandate that all educators go through training in mental health, trauma, mindfulness, and self-help strategies. 

“They are the first line of defense. It’s like any other kind of illness. You wouldn’t wait until you’re on your deathbed to try and strengthen your immune system,” Pozmantier said. 

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Puerto Rico marks 1 year since Maria with song and sadness

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SAN JUAN, Puerto Rico (AP) — Clapping and raising their hands to the sky, hundreds of people clad in white gathered at an 18th-century fort in the Puerto Rican capital on Thursday to remember the thousands who died in the aftermath of Hurricane Maria as the U.S. territory struggles to recover one year after the Category 4 storm hit.

Religious leaders and government officials recalled how Puerto Rico was ravaged by the storm that killed an estimated 2,975 people and caused more than an estimated $100 billion in damage.

Tens of thousands remain without adequate shelter or reliable electrical power, a sad fact that Gov. Ricardo Rossello noted on Thursday.

“After that catastrophic experience, we acknowledge how complex and difficult it is to prepare for a hurricane of that magnitude and fury,” Rosello said. “The best tribute we can give these people, these brothers that we’ve lost, is to build a better Puerto Rico for their sons, their grandsons and their families.”

While the U.S. government has invested billions of dollars to help clean up and repair the U.S. territory, much work remains. Major power outages are still being reported, tens of thousands of insurance claims are still pending and nearly 60,000 homes still have temporary roofs unable to withstand a Category 1 hurricane.

“I think it’s inexplicable,” Kumi Naidoo, Amnesty International’s secretary general, told The Associated Press during a visit to the island Thursday. “There’s no justifiable reason I can see for this gross level of negligence.”

Across the island, people marked the one-year anniversary with gatherings large and small, solemn and anger-tinged — and at times, even hopeful.

In the coastal fishing and farming village of Yabucoa, the strains of one of Puerto Rico’s most beloved songs filled the air at 6:15 a.m., the exact moment the storm made landfall there one year ago.

Tarps still covered many homes that have yet to be rebuilt in the town of 37,000, even as the nostalgic strains of “Amanecer Borincano” — “Puerto Rican Dawn” — resonated at the spot where Maria first unleashed its fury.

“I am the light of the morning that illuminates new paths,” a choir sang as dozens of local officials and residents gathered there. “I am the son of palm trees, of fields and rivers.”

In San Juan, the crowd of worshippers gathered at the 230-year-old San Cristobal fort sang and prayed along with pastors and musicians on stage, with music echoing through the fort’s heavy walls as the sun slowly sank into the sea behind them.

Pastor Elder Gonzalez said he and other volunteers who flew to Puerto Rico after the hurricane to help were shocked at what he saw from up high.

“To see the island of enchantment was a deep and painful experience,” he said. “No one on the plane said a word.”

Government officials argue that many changes have been made to better prepare Puerto Rico for future storms, but they acknowledge that significant obstacles remain.

Jose Ortiz, director of Puerto Rico’s Electric Power Authority, told reporters that 20 percent of repairs made to the power grid need to be redone. He said crews didn’t have access to the best materials at the time or were forced to rely on temporary fixes, such as using trees as makeshift power polls after Maria destroyed up to 75 percent of transmission lines.

In addition, municipal officials have complained that reconstruction efforts are too slow. Ariel Soto, assistant to the mayor of the mountain town of Morovis, said that 220 families there remain without a proper roof.

“We’re still waiting for help,” he said. “This hit us hard.”

In San Juan, among those still living under a blue tarp during the peak of hurricane season was Sixta Gladys Pena, a 72-year-old community leader.

“You worry, because you think it’s going to fly off like it did before,” she said. “We’ve lost an entire year and nothing has been resolved. You feel powerless.”

On Thursday, Ben Carson, secretary of the U.S. Department of Housing and Urban Development, announced in San Juan that $1.5 billion was being released to Puerto Rico as part of the overall $20 billion pledged for rebuilding, the largest in the agency’s history.

Officials said the priority is to help people still living under tarps, as well as those in low- and middle-income housing. The money will be used to repair and rebuild homes, relocate people and help them obtain property titles if needed.

“The path forward is challenging and will be measured not in months, but really in years,” Carson said.

In recent weeks, Puerto Ricans have become increasingly angry and frustrated as President Donald Trump touted what he said was a “fantastic” response to Hurricane Maria, calling it an “unsung success” as he denied the official death toll without presenting any evidence.

On Thursday, Trump issued a one-sentence statement on the one-year anniversary of Maria. “We stand with Puerto Rico, and we are helping them to rebuild stronger and better than ever before,” it said.

Nivia Rodriguez, a 60-year-old retiree whose uncle died a week after Maria, is among those disgruntled by Trump’s comments, as well as by videos of rescue crews responding to Hurricane Florence in North Carolina.

“They saved five dogs that were drowning,” she said of the rescue effort after Florence hit, adding that she feels Puerto Rico didn’t get the same treatment. “That hits you.”

Like many, Rodriguez hoped that after Thursday, she would no longer be bombarded by photos and videos that make her feel like she’s reliving Hurricane Maria.

“It’s too much,” she said.

But others felt that Maria’s tragic legacy still needs to be acknowledged, even long after the anniversary has passed. Among them was a group of artists unveiling an exhibition called simply, “6:15 A.M.”

Artist Omar Banuchi, who organized the exhibit, said he was reluctant at first, in part because he didn’t know how to approach the subject. “It’s something that affected all of us and keeps affecting us,” he said.

He said the exhibition walks a fine line, with some paintings showing beautiful landscapes alongside trailers set up by Puerto Rico’s forensics institute as part of the effort to try to identify the bodies of those who perished in the storm. There also will be live music that will incorporate sounds of the hurricane hitting the island.

“The point is for people to have a good time,” Banuchi said. “But there will be certain uncomfortable moments. … Maria is still a difficult topic.”

Videos from CNN

One year later, an open wound: How the federal government failed Puerto Rico after Hurricane Maria

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At that point, Congress had only approved $6.2 million for Maria victims. It took another week to get 70 helicopters flying above Puerto Rico, and even then, the island’s residents received thousands of fewer tarps and millions less liters of water and meals compared to their Texan counterparts. The USNS Comfort, a Naval ship often sent to disaster zones, was deployed only after pressure and even then, it sat empty for days.

I'm not losing hope as Puerto Rico is rebuilt from the ground up. You shouldn't either.

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A scene from protests in New York City earlier this year. Participants demanded more aid and resources for Puerto Rico's recovery.A scene from protests in New York City earlier this year. Participants demanded more aid and resources for Puerto Rico’s recovery.

Image: Spencer Platt/Getty Images

This week marks one year since Hurricane Maria tore through the Caribbean islands. As president of the Hispanic Federation, I am marking this somber anniversary by helping to launch a new campaign called “Take Action for Puerto Rico!” to ensure the island and its people have the financial and moral support they need to thrive. What I’ve seen in my multiple visits to Puerto Rico over the last 12 months has convinced me that human resilience, optimism, and community organizing will always outlast tragedy, but more work needs to be done. 

SEE ALSO: How a lesbian union president and evangelical nonprofit leader teamed up to get Puerto Rico clean water

In Puerto Rico, the devastation was as wide as it was deep. Power lines snapped under ferocious winds and roads were washed away by torrential downpours and mudslides. Roofs were ripped off homes, aggravating an already deepening housing crisis. The island’s electrical grid, weakened by Hurricane Irma some weeks earlier and by years of neglect, was completely shattered, leaving millions to fend for themselves during what became the longest power outage in U.S. history.

Human resilience, optimism, and community organizing will always outlast tragedy

Words fail to describe the damage done to the island’s inhabitants. Businesses closed. Schools were shuttered. Tens of thousands of Puerto Ricans, suddenly homeless and jobless, left the island for the mainland. Most heartbreaking of all, we know now that some 3,000 or more Puerto Ricans died as a direct result of the storm or its aftermath. Claims of “fake news” notwithstanding, the personal stories of those deaths and the tragedy that unfolded on the island in the storm’s wake are just now coming into focus.

Given the bleak landscape of post-Hurricane Maria Puerto Rico, it’s easy to fall into anguish and despondency. And yet, even if the challenges seem insurmountable, Puerto Ricans have displayed an almost superhuman level of resiliency that should inspire us all. Faced with a terrible natural disaster and with a patently insufficient federal response, Puerto Ricans have demonstrated that the future of the island will be led by local communities determined to build a new Puerto Rico. 

In February of this year, I traveled to Yauco, a town located in southwestern Puerto Rico. I was introduced to the work of the Centro Microempresas y Tecnologías Agrícolas Sustentables (CMTAS), a 70-acre education center for agricultural microenterprises that supports local communities and farmers through sustainable technology. 

The organization’s leaders understood that if Puerto Rico was ever to recover from the hurricane it would have to strengthen its agricultural sector. We were so impressed by CMTAS’ vision that they became one of our first grantees. The organization received emergency funds to provide furniture and appliances to over 30 small farmers and their families who lost their homes. It distributed solar lamps, water filters, mosquito nets, and food to thousands of families. The funding allowed the organization to construct a solarized well that will provide the community of Quebradas in Yauco and those in surrounding areas with clean water. They will be better prepared in the event of another disaster. 

Our support helped CMTAS restore pathways, fencing, and a hydroponic station on its model farm, replace livestock lost in the storm, and repair its teaching building so that it could reopen its school. Hispanic Federation is also helping install a pilot anaerobic bio-digester which will supply a free source of renewable, biogas energy to 15 nearby homes and the CMTAS school. Its goal is to develop an agro-tourism business that will help sustain these and other projects.

Volunteers from the United States and Spain help rebuild a home in Quebradillas, Puerto Rico.

Volunteers from the United States and Spain help rebuild a home in Quebradillas, Puerto Rico.

Image: Monica Tavares / hispanic federation

There are hundreds of other projects just like these across the island: Puerto Rican-led initiatives designed to strengthen Puerto Rico. Thanks to the generosity of more than 200,000 donors to our Unidos Disaster Relief and Recovery Fund, we were on the ground just a couple of days after the storm providing relief, coordinating with local groups to get aid to where it was needed most, and serving as a vital bridge between worried Puerto Ricans on the mainland and isolated Puerto Ricans on the island. 

We were able to deliver over 7 million pounds of food, water, and critical supplies to all of the island’s 78 municipalities. We coordinated 25 relief flights carrying medicine, first responders, and solar panels to aid those without electricity. We conducted medical evacuations and missions, bringing individuals in critical care to mainland U.S. hospitals and much-needed doctors and nurses to the people on the island. In less than a year we have committed $30 million dollars to community-based relief and reconstruction projects that are building a fairer and more resilient Puerto Rico. 

A farmer in Cayey, Puerto Rico, leading Hispanic Federation staff on a tour of land devastated by Hurricane Maria.

A farmer in Cayey, Puerto Rico, leading Hispanic Federation staff on a tour of land devastated by Hurricane Maria.

Image: Monica Tavares / hispanic federation

As much as I can be proud of Hispanic Federation’s efforts in Puerto Rico, and humbled by the solidarity of hundreds of thousands of people who gave time and treasure to support Puerto Ricans in their time of need, what makes me prouder still is to have witnessed the determination and creativity of Puerto Ricans who refuse to surrender their island to the storm.

Yet in order to see local initiatives and projects through to fruition, Puerto Rico needs help — a great deal of help. The kind of help that only a significant federal investment can provide. Unfortunately, the federal response to the crisis on the island has been inhumane and inadequate. 

That’s why this week we are joining with 250 organizations across the United States for the month-long “Take Action for Puerto Rico!” campaign. We are all coming together to demand a recovery plan for the island that is just and sustainable, and to call on the federal government to finally honor its responsibility and duty to the people of Puerto Rico. 

While the events taking place during the campaign will vary, all of the participating groups have committed to take action around four critical pillars for Puerto Rico’s recovery: empowered community, health care equity, climate change preparedness, and economic redevelopment.

So many of us want to help Puerto Rico get back on its feet, and to stand stronger than before. We can do that by supporting Puerto Rican recovery efforts that are grounded in local realities and local needs. Our campaign does that, with the aim of achieving maximum impact for Puerto Ricans living on the island. This moment, though born from catastrophe, has brought us an opportunity to fundamentally change Puerto Ricans’ lives for the better. Let’s not waste it. 

José Calderón is president of the Hispanic Federation. The mission of the Hispanic Federation is to empower and advance the Hispanic community. 

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Tapper: 'Puerto Ricans are Americans too, Mr. President'

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Read more >”,”imageUrl”:”//cdn.cnn.com/cnnnext/dam/assets/170127111336-perspectivas-trump-taxes-mexico-large-169.jpg”,”title”:”Fact check: Would Trump raise his own taxes?”,”videoCMSUrl”:”/video/data/3.0/video/politics/2017/05/06/fact-check-donald-trump-tax-rate-orig-ct.cnn/index.xml”,”videoLeafUrl”:”/videos/politics/2017/05/06/fact-check-donald-trump-tax-rate-orig-ct.cnn”,”videoId”:”politics/2017/05/06/fact-check-donald-trump-tax-rate-orig-ct.cnn”,”videoUrl”:”/videos/politics/2017/05/06/fact-check-donald-trump-tax-rate-orig-ct.cnn/video/playlists/fact-check/”},{“descriptionPlainText”:”Jake Tapper, with FactCheck.org, looks into President Trump’s claim about Obama’s red line with Syria in wake of another chemical attack. 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