Puerto Rico residents began leaving pairs of shoes outside the island’s Capitol building in San Juan on Friday after learning this week that the death toll from last year’s Hurricane Maria might have been 70 times higher than the official government tally of 64.
The shoes, arranged in neat rows, formed an impromptu memorial for the dead as people held protest signs nearby.
The island’s government is facing criticism from residents angry at the lack of transparency surrounding the official death toll, which remains murky. Nearly six months after a New York Times report suggested 1,052 deaths may have been linked to the hurricane, a research team led by Harvard University put the figure even higher, at 4,645.
Late Friday, the Puerto Rico Department of Health released data that showed a sharp year-over-year increase in fatalities in the months after the hurricane hit. There were at least 1,400 additional deaths from September through the end of December 2017 compared to the same time period in 2016.
“The government doesn’t even know how to count the dead,” read one man’s sign, according to NPR.
“4,645 dead and my daddy was one,” read another.
One woman held a sign simply reading “genocide.”
Maria’s devastation was not limited to drownings and debris. The storm knocked out power to nearly the entire island, with repair efforts stretching several months, and it cut off access to clean drinking water for more than half the population. Researchers say many of the deaths resulted from inability to access medical care, particularly affecting those who were elderly or sick.
Puerto Rico Gov. Ricardo Rosselló said his government is still awaiting results from a study on the death toll commissioned from George Washington University.
This article originally appeared on HuffPost.