Millions of people in Puerto Rico remain without electricity in the wake of Hurricane Maria, a new image taken by a US government satellite shows.
Outside the capital city San Juan, residents are still isolated without power or communications, and it may take months to restore, officials warn.
Clean water and medicine are also scarce, locals residents report.
The island's governor warned on Monday of a "humanitarian crisis occurring in America", and called for more aid.
"Puerto Rico is part of the United States, and we need to take swift action," Governor Ricardo Rossello told CNN.
"This is a major disaster," he added, calling on the US Congress to produce "something tangible, a bill that actually answers to our need right now".