In an escalating war of words with President Donald Trump, the mayor of San Juan slammed the president for tossing rolls of paper towels to hurricane survivors in a beaming photo op, calling the image "terrible and abominable."

Trump traveled to Puerto Rico Tuesday amid criticism that he neglected the storm-torn island after Hurricane Maria, which killed 34 people. Trump tossed the paper towels into the crowd of storm survivors and handed out flashlights at the Calvary Chapel while joking, "You don't need them anymore"—though most of the island remains without power.

“This terrible and abominable view of him throwing paper towels and throwing provisions at people, it’s really—it does not embody the spirit of the American nation, you know,” Mayor Carmen Cruz told MSNBC. “That is not the land of the free and the home of the brave that the beacon of democracy that people have learned to look up to, you know.”

Cruz called Trump's visit a "17-minute public relations meeting." She said Trump ignored her when she told him, "It’s about saving lives; it’s not about politics." 

Cruz said Trump also ignored other mayors in Puerto Rico, who have worked to provide aid and resources to the American people. Trump later congratulated Puerto Rico on avoiding the death toll of “a real catastrophe like Katrina,” which killed around 1,800 when it struck the Louisiana coast in 2005, and he told local officials that the disaster has "thrown our budget a little out of whack because we've spent a lot of money on Puerto Rico."

Hurricane Maria hit the island September 20, destroying homes and leaving residents stranded without communication. The storm destroyed crops, storefronts and homes across Puerto Rico. Governor Ricardo Rossello estimated the total cost of damage at $90 billion across the island, which already struggles with poverty.

During his tour of homes on the island, Trump met with pre-selected Puerto Rican families—telling one to "have a good time," and left the island with a remark that he "only heard thank-yous" from the American citizens there. On Wednesday morning, Trump posted on Twitter: "A great day in Puerto Rico yesterday. While some of the news coverage is Fake, most showed great warmth and friendship."

Trump was criticized for his administration’s reaction time in delivering relief efforts to Puerto Rico and for the timing of his visit to the island, where 3.5 million American citizens live. Oxfam International, an organization that typically provides aid to the world's most impoverished regions, said that given the "slow and inadequate" response from the U.S., it will help Puerto Rico—a rare rebuke from the charity to a first-world country.

On Twitter, images of the president tossing paper towels to Hurricane Maria survivors like they were prizes circulated quickly, with some comparing them to Trump practicing shooting a basketball:

The president's battle with Cruz began when she criticized the White House for calling Puerto Rico a "good news" story, striking back with the reminder that "people are dying" and "this is a life or death story" as people struggle to get food and water. Trump quickly attacked the mayor, condemning her for supposedly poor leadership.

"The Mayor of San Juan, who was very complimentary only a few days ago, has now been told by the Democrats that you must be nasty to Trump," the president wrote Saturday. "Such poor leadership ability by the Mayor of San Juan, and others in Puerto Rico, who are not able to get their workers to help. They want everything to be done for them when it should be a community effort. 10,000 Federal workers now on Island doing a fantastic job."