Last week, Puerto Rico was lucky. This week, it’s not. The majority of the U.S. territory was spared the worst from Hurricane Irma, the Category 4 storm that devastated the lower Florida Keys and Caribbean islands including St. Martin and Barbuda. But now Hurricane Maria, a Category 5 monster with 165 mph winds, is headed straight for the heart of the island; every meteorological prediction shows the storm pummeling Puerto Rico. Rain is already falling, and the eye is expected to hit as early as Tuesday evening.

“[Maria] will essentially devastate most of the island,” Puerto Rican Gov. Ricardo Rosselló said in a Monday interview with USA Today. Most of the nation’s 3.4 million residents will lose power, structures will be destroyed, and neighborhoods will be flooded. There will be food and supply shortages. People will die. And the recovery will be especially difficult due to Puerto Rico’s bankruptcy and the $1 billion in damage wrought by Irma. But on top of all this, Maria could worsen the many environmental calamities that already exist on the island, posing even greater threats to public health—particularly in low-income areas—as boricuas struggle to recover from the storm. 

In some ways, Puerto Rico will face familiar environmental threats caused by major hurricanes, but they’ll be compounded by the island’s financial and environmental woes. For instance, wastewater pumping systems failed in Texas and Florida after Hurricanes Harvey and Irma, causing major sewage spills. The same will likely happen in Puerto Rico, where most pumping stations run on electric power, but may be much worse due to the island’s “degraded and unsafe” electricity system. The local energy authority has already said it could take up to four months to restore power, likely resulting in prolonged sewage releases. 

Also like Florida and Texas, Puerto Rico has Superfund sites—23, to be exact—that risk contaminating soil and groundwater, one of which is among the most complicated, expensive Superfund sites in the U.S. For six decades, the military used the Puerto Rican island of Vieques as a bomb-test site, resulting in widespread contamination of three quarters of the small island. Many claim this contamination has caused the heightened cancer rates among the 9,000 people who live there. Unexploded bombs, bullets, and projectiles are all over Vieques, according to Judith Enck, the former EPA administrator for Region 2, which covers Puerto Rico. “I am concerned that the ones on the land will wash into the sea,” she said.