HAITI — Haiti had only just begun rebuilding from a devastating earthquake five years ago when Hurricane Matthew tore through the small Caribbean nation on Tuesday, killing hundreds in its path and inundating entire villages.
Once again much of the country is a disaster zone, with powerful Matthew shredding homes and engulfing communities in knee-deep water that is taking time to recede.
At least 271 people have been killed since Matthew made landfall in Haiti as a Category 4 hurricane, and officials in the country warn that the death toll is only likely to rise. Reuters reported that at least 339 people had been killed in Haiti, citing local officials.
“We have nothing left to survive on, all the crops have gone, all fruit trees are down, I don’t have a clue how this is going to be fixed,” said Marc Soniel Noel, the deputy mayor of Chantal in the affected region.
The current death toll does not take into account potential loss of life in the far southwest of the country, which have yet to be assessed due to “communication issues,” the Civil Protection Service said.
For now, the focus is just reaching victims, as the only bridge linking the capital Port-au-Prince to the worst-affected south and west has been damaged beyond use.
Local man Idalbert Joseph says he hasn’t heard anything since Monday from the 19 teachers he supports in Haiti.
“I’m still waiting to see on my computer if they send some message to me,” Joseph said “They always send me some message by What’s Up. They always send me something by Facebook. And Tweeters, I always hear something from them. But this time, no electricity in this part of the northwest area. So that’s why no communication. The cellphone is probably dead.”
By Thursday, the bridge that spans the Rivière la Digue in Petit-Goâve was partially passable, though still unfit for large-scale aid deliveries.
Conduit roads too are blocked by collapsed palm trees and debris, forcing agencies to consider air dropping of supplies as the skies clear and flying becomes a safer option.
‘Emergency after an emergency’
Not only are logistics a major challenge, the magnitude of the disaster appears to have been wildly underestimated.
“In the city of Jeremie in the west, there were only five planned evacuation centers there, but in the last 48 hours, that’s popped up to 25 centers. These are just makeshift shelters,” CARE USA emergency communications manager Holly Frew told CNN Friday.
She said that there was a “massive influx” of people to the shelters, which are struggling to find space for people cramming together to sleep on the floor.
“The priority is to get food and water to these people. Of course aid agencies like us had supplies pre-positioned before the storm, but there’s only so much you can do in a storm this size, and as the number of centers has more than doubled, the need has risen,” Frew said.
She explained that the people in the affected region had already been suffering from drought before the hurricane hit.
“The people here are very resilient. They’re used to these recurring disasters, but that doesn’t make it easy,” she said.
“People have lost a lot. Some of those who bore the brunt of the storm are still in a state of shock. But some caught in the eye of the storm are feeling lucky to be alive.”
Ariane Quentier, spokeswoman for the UN Stabilization Mission in Haiti, said: “What we are realizing, as we are going further … is that there’s been a lot of devastation and a lot of damage and probably a lot more than what we had initially assessed.”
Haiti was only just beginning the “development” phase to rebuild infrastructure following the 2010 earthquake that destroyed much of the country, said Ines Brill, the International Federation of Red Cross and Red Crescent Societies representative for Haiti.
“This is an emergency after an emergency, which makes things more complex than a typical disaster,” she told CNN.
She said she believed some 80% of people had lost their homes in the worst-affected areas.
“But we still don’t know the real extent of the damage as the infrastructure problems have slowed things down. We are just now trying to start an impact assessment,” she said.
“We have to have a humanitarian bridge to reach the population.”
Dr. Charles-Patrick Almazor, chief medical officer in Haiti for Partners in Health, told ABC News: “Though the storm has passed, experience tells us that the worst is yet to come. What would be the immediate need is to make sure that people get safe drinking water and safe water for washing.”
Hurricane Matthew’s ferocious impact left 350,000 people in need of assistance and forced about 15,000 residents into shelters, according to UN Office for the Coordination of Humanitarian Affairs (OCHA).
Kevin Novotny, country director for Save the Children in Haiti, said staff based in Les Cayes observed that “a lot of houses are destroyed there. Anything with a tin roof lost it.”
UNICEF had warned on Wednesday that Haiti is facing the largest humanitarian crisis since the 2010 earthquake, which killed at least 220,000, injured 300,000 and displaced 1.5 million people.
Haitian officials postponed the presidential elections, which had been scheduled for Sunday, due to the hurricane.
Cholera epidemic could worsen
Images showed residents wading through muddy waters and farm fields choked with flood waters as crops floated lifelessly.
The impact of the hurricane immediately raised public health concerns, especially about the availability of clean water, food and shelter.
Dave Brodsky, president of Chanje Movement, a California-based church partnership that has been working in Haiti since the 2010 earthquake, said he observed homes leveled with mud among other problems.
“There are sanitation issues because the standing water is mixing with human waste and animal waste,” he said, speaking to CNN from Croix-des-Bouquets, a major suburb to the northeast of the capital.
The “poorest of the poor” have been worst hit by flooding, he said.
Partners in Health warned that the hurricane would likely worsen the country’s cholera epidemic.
Cholera is an acute gastrointestinal illness caused by ingesting food or drink contaminated with Vibrio cholera bacteria. It can cause severe diarrhea and vomiting, which leads to extreme dehydration.
A cholera outbreak following the 2010 earthquake in Haiti killed at least 10,000 people. Earlier this year, the UN acknowledged its own involvement in the devastating epidemic.
The Pan American Health Organization sent epidemiologists with cholera experience this week to Haiti.
Heart to Heart International in Lenexa is helping with hurricane response in Haiti and the southeastern United States.
Its advance team is already in Haiti assessing Matthew’s impact, and they are about to send more help.
13 people are already in Haiti to help along with hundreds of employees scattered across the island. Tens of thousands of hygiene kits and “doctor go” boxes, which is basically what an old-school house call doctor would use, are getting boxed up and prepared for shipment inside the hub in Lenexa.
Click here for the latest information on Hurricane Matthew from the National Hurricane Center.