Trump gives his Puerto Rico response a 10 despite 85% of island still lacking electricity

Donald Trump says that his administrations response to the disaster in Puerto Rico deserves a grade of 10 out of 10, even though much of the island is still without power nearly a month after Hurricane Maria smashed through the US territory.

The President boasted of his own administration’s work during a meeting in the Oval Office with the US territory’s governor, Ricardo Rossello. The Puerto Rican governor notably avoided the question when asked how he’d rate the US federal government’s response.

“I think we’ve done a really great job,” Mr Trump said. “I give ourselves a 10 [because] we have provided so much, so fast.”

Three weeks after Maria made landfall on the US territory, as much as 78 per cent of the island is still without power, endangering vulnerable populations in hospitals and elsewhere. Ninety-eight per cent of the hospitals on the island are reportedly open, but they are hobbled by unsteady access to electricity. Of those hospitals with generators, the influx of patients from other hospitals that don't have the resources to serve their patients has put strains on doctors and medical professionals there.

Emergency health services are also paralysed in many places, leaving many sick people trapped in their homes without access to phone services to call for help, and without access to their medications. People with lifelong medical conditions are particularly vulnerable, and many are being forced to go without the medications they need to survive.

In parts of the island, the supplies of life-saving medications like oxygen and insulin are running out, and some have spoiled. In some scenarios on the island, there simply isn't enough to go around already.

The dire medical situation on the island has led to deaths, though many of those may not be accounted for in the official death toll of 48 people. That's because, in areas that are harder to access, the deaths may not be officially certified. Reports of bodies piling up at some hospitals have hinted that the number of deaths may end up being much higher than currently reported.

Mr Trump has appeared openly resentful of the notion that the United States is obligated to provide aid to Puerto Rico, a US territory with 3.4 million American citizens, and has been repeatedly criticised for that perceived attitude. He tweeted last week that "we cannot keep [the Federal Emergency Management Agency (FEMA)], the Military & the First Responders, who have been amazing (under the most difficult circumstances) in P.R. forever!"

While visiting, the President also commented on the cost of the disaster relief, telling local officials there that they had thrown the US federal budget "out of whack".

Some in Mr Trump's administration appear to have a tenuous grasp on Puerto Rico's legal status, with Energy Secretary Rick Perry referring to the island as a "country" on the same day as that tweet, while fielding questions about efforts to repair the island's energy grid.

FEMA says that there are more than 20,000 federal civilian personnel and military members, including 1,700 FEMA personnel, who are in Puerto Rico and the US Virgin Islands. That response includes a Department of Defense hospital ship, the USNS Comfort, which is reportedly underutilized, since people on the island aren't sure how to get patients to the boat.

The emergency management agency has provided millions of meals and millions of liters of water to distressed people in Puerto Rico. The governor of the island has established 10 regional staging areas around the island to aid in the distribution of aid, and is reportedly working alongside the National Guard in that mission.