Hurricane Matthew arrived thrashing at the door of Rosemika’s house in Croix-des-Bouquets at 6am on Tuesday.
“It happened so quickly and suddenly,” the 10-year-old told aid workers. “I heard my neighbour screaming: ‘Water! Water everywhere!’ It had completely surrounded us.”
Rosemika and her brothers and sisters ran, terrified, to the sanctuary of the hills. Like some of her friends in Haiti’s Ouest department, they lost their home to the fury of the wind and the rain.
The water “was like a monster, hitting everything violently,” she said.
Three days after the hurricane tore through the poorest country in the western hemisphere, taking with it thousands of homes, the scale of the destruction is only just beginning to emerge.
Communications in the worst-hit departments of Grand’Anse and Sud are still badly affected and the loss of a bridge connecting the capital, Port-au-Prince, to the south-west is frustrating the relief effort.
There were fears by Friday afternoon that almost 600 people had been killed, but it will take days before a definitive toll can be established.
A Reuters tally of deaths reported by local civil protection officials suggested 842 people had died, but that figure has not been confirmed by the government or the civil protection agency. The government put the figure at nearly 300 and Radio Television Caraibes 264. Hervé Fourcand, a senator for Sud department, said more than 300 people had died in the region alone.
The International Federation of the Red Cross and Red Crescent Societies estimates that more than a million Haitians have been affected, with hundreds of thousands of people in urgent need of humanitarian assistance. It has launched a £5.8m appeal to help provide medical relief, shelter, water and sanitation over the next year.
The devastation has prompted the authorities to postpone the presidential election scheduled for Sunday as they try to gauge the scale of the country’s worst natural disaster since a devastating earthquake struck the country in January 2010.
Many victims were killed by falling trees, flying debris and swollen rivers when Matthew hit, bringing winds of 145mph.
Most of the fatalities were in towns and fishing villages around the western end of Tiburon peninsula in the south-west of the country, a region of Caribbean white sand beaches and rivers backed by hills.
Saint-Victor Jeune, an official with the civil protection agency working in the mountains on the outskirts of the devastated city of Jérémie in Grand’Anse department, said his team had found 82 bodies that had not been recorded by authorities in the capital because of patchy communications. Most appeared to have been killed by debris.
“We don’t have any contact with Port-au-Prince yet and there are places we still haven’t reached,” Jeune told the Associated Press as he and his colleagues searched the area.
The Haitian government, UN agencies and NGOs are now trying to get food, water and temporary shelters to those who have been stranded for three days already.
“We are only now beginning to see the full scale of the damage as we begin to reach more of the communities that have been cut off,” said Marie Therese Frederique Jean Pierre, Plan International’s country director in Haiti.
“Roads and bridges were severely damaged by the hurricane, so there are still some rural areas that we have been unable to reach.”
Prospery Raymond, Christian Aid’s Haiti director, said the charity’s efforts to get vital supplies out of Port-au-Prince were being hindered by traffic jams at river crossings. He also said there was a serious shortage of food in the badly-hit southern port town of Les Cayes.
“People are trying to cope together,” he said. “After the earthquake, some people don’t want to be in camps. They’re living in their gardens even if there’s nothing left and trying to grab protein from breadfruit. But for how long?”
Christian Aid has launched an appeal to help see people through the next few months by giving them water, food and cash, but Raymond said that money would also be needed to rebuild houses and buy seeds and livestock for farmers who had lost everything.
One of the biggest concerns is that Hurricane Matthew could provoke a surge in the cholera epidemic that has killed almost 10,000 Haitians since it was unwittingly introduced to the country by UN peacekeepers after the 2010 earthquake. To that end, NGOs and others are distributing soap, chlorine tablets and hygiene kits to the most vulnerable areas.
“Diarrhoea and cholera are a looming threat with flooding causing sewage to flow into the streets,” said Yolette Etienne, ActionAid’s country director. “Continued rain and flooding could cause water-borne disease to spread further.”
The immediate priority will be containing the humanitarian crisis, but work is already under way to try to plan for the coming months and years.
Yvonne Helle, the UN Development Programme’s Haiti director, said people in Grand’Anse had lost everything - their houses, their fruit trees and their fields. With 80% of the crops in the south thought to have been washed out, its people had “basically lost their entire livelihoods and their food source”.
“It’s devastating,” she said, adding that the residents of the extremely poor rural area had no backup or safety net besides the remittances they receive from relatives overseas.
“Of course we need to focus on the humanitarian and keep everybody alive,” she said. “But we also want to get people back to their homes as soon as possible to rebuild, replant and pick up their lives.”
