Four days after a monster hurricane ripped through Haiti, a grim trail of destruction and death on the Caribbean island continued to come to light.
A United Nations report listed 271 deaths in the wake of Hurricane Matthew, while other outlets such as Reuters news agency reported Saturday that the toll was approaching 900. Fridnel Kedler, coordinator for the Civil Protection Agency in Grand-Anse, told the Associated Press at least 470 were dead in the hard-hit southwestern corner of the country.
Christy Delafield, a senior spokeswoman with global relief agency Mercy Corps, told USA TODAY on Saturday the real death toll may never be known. "We may never really understand the toll fully," Delafield said. Haitians in remote villages have already begun burying their dead, she said.
The United Nations Office for the Coordination of Humanitarian Affairs said 750,000 people in Haiti, the poorest country in the Western Hemisphere, are in need of humanitarian assistance. Of the 10.3 million people in Haiti, 1.3 million have been impacted by the storm, OCHA says.
Among the most alarming fallout of the storm was word on new cases of cholera, an infectious and often fatal bacterial disease of the small intestine usually transmitted by tainted water supplies. Haiti has been struggling to recover from a massive earthquake in 2010 and an ensuing cholera epidemic, which killed more than 7,000 people.
Delafield says she is aware of four new cases of cholera. Reuters reported 17 cases were detected in Chardonnieres on the southern coast.
It has been a struggle for relief agencies to access those in need in remote sections of the island. Matthew slammed the western tip of Haiti on Tuesday with 145-mph winds in an area of rural countryside that soon became cut off from the rest of the nation when a bridge gave out, complicating relief efforts.
Humanitarian agency World Vision said Saturday that access to some areas was starting to improve. Cell service was returning and government officials were starting to hear from the mayors of outlying cities with information about the conditions in their areas. The group delivered relief supplies to 1,000 households on Friday and was gearing up for more relief over the weekend.
People keep asking, “When is this going to stop? When are we going to get a break from crisis after crisis?” said John Hasse, national director of World Vision in Port-au-Prince. "They’re tired and discouraged. And yet, somehow, they just keep getting back up and rebuilding again.”
World Vision's Guy Vital-Herne, working with crews in the southern part of the country, said access to clean water is a growing concern. "Pipes have broken in homes, but people can’t leave their neighborhoods to buy clean water. In some towns, the water sources have been contaminated." he said.
Haiti is one of the most deforested countries in the world, making it more vulnerable to windstorms and heavy rain. The sloping, mountainous areas were also at risk of landslides. The area hit hardest by the storm is populated by villages where Haitians live in shacks of wood, corrugated steel and even mud. The storm tore off rooftops and flattened others to their foundations. Hundreds of thousands of people have been left homeless, Reuters reported.
Donna Porstner of Americares said Saturday that the disaster relief agency was "working non-stop" and coordinating with the Ministry of Health in Haiti.
"Americares' emergency response teams in Port-au-Prince and Les Cayes are assessing survivors’ health needs and coordinating aid shipments," she said. "So far we have delivered two shipments of medicine and relief supplies to Les Cayes, and we have more on the way."
Porstner said drivers navigated treacherous roads to deliver the medicine and supplies such as oral rehydration salts, wound care treatments and intravenous fluids. Americares has about $1.6 million in aid on the way to Haiti, she said.
The United Nation's Population Fund said Saturday that it was concerned about the fate of more than 8,400 pregnant women who are expected to give birth in the next three months, as well as 1,200 women who would need cesarean sections. The agency was sending 252 emergency reproductive health kits to parts of the nation.
"Hurricane Matthew delivered a severe blow to Haiti's health facilities, whether by flooding these centers or blowing off their roofs and putting them out of service," said Babatunde Osotimehin, UNFPA executive director. “We will work to help women give birth and live, despite this tragedy.”
On Saturday, Delafield was en route to Nippes in the southern part of the country on a mission to deliver hygiene kits containing such items as toothbrushes, shampoo and laundry soap. Mercy Corps hoped to deliver 5,000 kits to those in the mountainous areas.
The U.N.'s World Food Programme estimates up to 80% of harvest has been lost in many areas in Haiti as well.
"Haiti has been hit time and again with major disasters," Delafield says. "They just had the most severe drought in 50 years. This was the first year people had hoped for a good harvest."
No matter what the official numbers end up being, Delafield said the losses are overwhelming. "People lost their homes, all their crops. They wonder how can I rebuild my home? I have no money to provide food for family, to heat my home, to repair walls that have collapsed."
It has "been devastating, completely devastating," she said.