JEREMIE, HAITI >> At least 470 people have died in just one district of the southwest region of Haiti devastated by Hurricane Matthew as the country braces for a rise in cholera cases and grapples with what could become the worst humanitarian crisis since a catastrophic 2010 earthquake.
The coordinator for the Civil Protection Agency in Grand-Anse, Fridnel Kedler, told The Associated Press on Saturday that officials still have not been able to reach two communities in that department three days after Matthew hit as a Category 4 storm.
"The death toll is sure to go up," he said.
Haiti's government has estimated that at least 350,000 people need some kind of assistance, and officials are especially concerned about Grand-Anse, located on the northern tip of the southwest peninsula, where they believe the death toll and damage is highest. When Category 4 Hurricane Flora hit Haiti in 1963, it killed as many as 8,000 people.
Haiti's overall death toll remains unknown. Death counts are frequently difficult to tabulate in the immediate aftermath of a natural disaster in any country, though it is particularly difficult in remote and mountainous southwest Haiti.
Reports of deaths in those areas were slow to reach the Civil Protection Agency's headquarters in Port-au-Prince, where authorities said Saturday that the official death toll for the whole country so far was 336 people. It wasn't immediately clear whether some of the 470 deaths in Grand-Anse were included in that count. The agency also said that more than 60,000 people remained in shelters.
Health officials in Jeremie, the main city of Grand-Anse, were reporting a growing number of cholera patients as clinics struggled to emerge from the storm's aftermath.
Petuelle Fontaine, a health worker overseeing the open-air cholera treatment center in a corner of Jeremie's main hospital, said they were ill-equipped to deal with patients. The area was strewn with broken tree branches.
"We have no cholera vaccines here. None," she said as sweat dripped from her brow while she tended to the sick.
Eighteen patients arrived on Friday, and another nine showed up early Saturday.
Among them was Bellot Phafoune, a heavily pregnant woman who said she started getting cholera symptoms on Friday after eating a meal.
"I didn't want to take any chances and rushed here," said Phafoune, who was from a rural village about an hours' drive away from Jeremie.
The Pan American Health Organization and other groups have warned of a surge in cholera cases because of the widespread flooding unleashed by Matthew. An ongoing cholera outbreak had already killed roughly 10,000 people and sickened more than 800,000 since 2010, when the infectious disease was introduced into the country's biggest river from a U.N. base where Nepalese peacekeepers were deployed.
U.N. officials said the agency's Central Emergency Response Fund was releasing $5 million to help Haiti. Earlier this week, the fund released a loan of $8 million to UNICEF to boost response to Haiti's cholera epidemic.
Amid the suffering, aid began pouring into the coastal town of Jeremie, where thousands of homes were damaged or destroyed and many people were running low on food. Dozens of young Haitians came to the small airstrip along the coast to watch as a helicopter was unloaded with crates of food and water.
"My home is totally wrecked and I heard they were bringing food," said Richard David, 22, one of those who came to the airport. "I haven't had anything but water today and I'm hungry."
Solette Phelicin, a mother of five who lost her home and her small fruit and vegetable plot, watched from her yard as U.N. peacekeepers patrolled the airstrip. She said they were hungry and desperately needed food.
"Jeremie might get rebuilt after I'm dead, maybe, but I doubt it," she said.
The storm left signs of devastation all around the southwestern peninsula. Outside Jeremie, home after home was in ruins. Drew Garrison, a Haiti-based missionary who flew in Friday, said several fishing villages were submerged and he could see bodies floating in the water.
"Anything that wasn't concrete was flattened," said Garrison, whose organization, Mission of Hope Haiti, based in Austin, Texas, was bringing in a barge loaded with emergency supplies on Saturday. "There were several little fishing villages that just looked desolate, no life."
In Jeremie, Jislene Jean-Baptiste surveyed what remained of the one-room house that the grandmother shares with her three daughters and their children. There wasn't much left. Storm surge flowed across the road and drenched everything she owns in waist-deep salt water, washing away the stores of rice and sugar she regularly sold at the market to support her family. Then the wind tore off her roof.
"That storm was the most terrifying thing that ever happened here," she said.