Puerto Rican food aid is appallingly unhealthy

Puerto Rican food aid box
CC BY 2.0 USDA -- An emergency response worker hands out food boxes in Puerto Rico, October 2017

Food boxes distributed in the wake of Hurricane Maria consist of candy, chocolate, and pre-packaged meals that exceed recommended levels of salt, sugar, and fat.

After Hurricane Maria ravaged Puerto Rico last fall, the island was plunged into a state of humanitarian crisis. The electricity grid was severely damaged, much of the population suffered catastrophic damage to their homes, and hundreds of people were killed or missing. The relief effort by the Federal Emergency Management Agency (FEMA) was slow in coming and has been criticized by many, not least of all for the poor quality of the food it has been distributing to affected Puerto Ricans ever since.

When public health professor Uriyoán Colón-Ramos of George Washington University saw on social media how nutritionally deficient FEMA's food boxes were, she traveled to Puerto Rico to study the situation more closely. She and her group analyzed ten days' worth of food shipments being held at a FEMA distribution center in Barranquitas, six weeks after Maria hit. NPR reports:

"They found that 11 of the 107 different food items in the warehouse were candy and chips, including M&Ms and Twizzlers. And every item in the fruit category, which included sweetened fruit cups and applesauce, exceeded the Dietary Guidelines for Americans' recommendations for added sugars. Eighty-three percent of veggies, which were all canned, exceeded the recommended content of sodium."

Colón-Ramos figured that, even if the chips and candy were removed from the equation, a typical day of meals made with FEMA-provided foods would include "a ready-to-eat cereal and milk for breakfast, a morning and afternoon snack like dried peanuts or a cereal bar, tuna salad and crackers for lunch and a pre-packaged pasta dinner." These would meet DGA food group recommendations, while exceeding dietary limits for sugar, salt and fat.

She presented her findings at the Nutrition 2018 meeting in Boston earlier this month, asking the crucial question, "As a public health nutritionist, I just don't know why we are providing these foods. How did these foods end up there, and who was monitoring them?"

NPR says that these shelf-stable foods weren't even the ones that Puerto Ricans needed most; many snack foods were still available in corner grocery stores post-hurricane. It was fresh vegetables, fruit, milk, and meat that were impossible to get. These were the kinds of ingredients that FEMA should have been bringing in, not overly refined, pre-packaged foods.

The obvious counter-argument is that perishable foods are not conducive to travel and distribution, but Puerto Rico is not a long flight from the U.S. Considering the level of need, it's a fair bet that fresh produce and other ingredients would have been snatched quickly from a distribution center, not left to linger.

As Colón-Ramos told her audience in Boston, times have changed from the days when food aid focused entirely on providing calories regardless of their quality. This is now an 'outdated' way of looking at it. We can and need to move beyond this mentality.

Puerto Rico already suffers from a high obesity rate, with 30 to 35 percent of adults falling into this category. To provide foods that perpetuate this cycle is inconsiderate and irresponsible, as it can create even more health problems for the island residents. We don't want the repercussions of aid to have repercussions on health. Candy may be a special, spirit-boosting treat for kids in difficult times, but when it comes in large quantities, without other healthy foods to balance it out, and no toothbrushes and toothpaste to ensure clean teeth afterwards, it could be a recipe for further trouble.

It is interesting to watch a FEMA box 'unveiling,' posted on Facebook by Rudolfo Reddog in April. The box contains 12 meals in the form of fruit cups, boxes of raisins, bags of Goldfish crackers, and small cans of baked beans. Reddog expresses gratitude in his caption, saying, "Still counting my blessings and thankful for the lil help that is available. The people that fight for us to even get this much, work very hard to get this to our homes." But he adds wryly in the video, "Maybe you might be in a disaster and you're thinking your government is going to come to the rescue with some super meal... (laughs)"

Dealing with hunger and deprivation at a time of crisis is incredibly challenging for everyone, but surely FEMA could have done better than this. At the very least, it can learn for the next time.

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