In an island nation still recovering from a devastating earthquake and now smashed by one of the strongest storms in a decade, the true extent of the damage in Haiti from Hurricane Matthew may not be clear for days.

Early Wednesday, communication had been almost entirely cut off in the hardest hit southwestern end of the country and the toll of 11 deaths across the Caribbean will undoubtedly rise as word trickles in from the devastated communities.

“What we know is that many, many houses have been damaged,” Haitian Interior Minister Francois Anick Joseph said. “Some lost rooftops and they’ll have to be replaced while others were totally destroyed.”

The main bridge to the southern region was washed away and mobile and landline networks are down.

Haiti, with a population of 11 million, is the poorest country in the Western hemisphere and has tens of thousands of people still living in tents after a powerful earthquake six years ago killed 200,000 people.

Infrastructure is, in general, poor and many people live in rudimentary shacks crowding the hillsides that are especially vulnerable to the high winds and lashing rains of a hurricane — as well as the landslides that often take place afterward.

The United Nations is calling Matthew “the largest humanitarian event” in Haiti since the earthquake and said “much of the population” has already been displaced, according to Mourad Wahba, the deputy special representative for Haiti.

He said that at least 10,000 people were in shelters, and the country was running short of clean water.

Images posted on social media Tuesday showed raging, muddy floodwaters nearly overflowing river banks and driving wind and rain that bent palm trees nearly in half. The winds sheared roofs from ramshackle houses, uprooted trees, washed out bridges and clogged rivers and roads with debris.

Everywhere people could be seen were wading through the streets where water levels in some places reached shoulder height.

In one dramatic video, a man shouted in English, “Pray for us,” as Matthew lashed the small port of Les Cayes on Haiti’s southwestern coast. A major concern in such low-lying areas is the persistent danger from flooding and mudslides, relief officials said.

“It’s much too early to know how bad things are but we do know there are a lot of houses that have been destroyed or damaged in the south,” Marie Alta Jean-Baptiste, director of Haiti’s Civil Protection Agency, told the Associated Press.

Heavy rain is expected to continue pounding Haiti in the hurricane’s wake with up to 40 inches in some remote areas.

UNICEF has warned that more than 4 million children are risk in the country, especially from waterbourne disease because of the lack of clean water.

According to the U.S. State Department, USAID has deployed emergency response teams to Haiti and prepositioned relief supplies such as shelter kits and sanitation necessities, to help out in the aftermath.

The U.S. Navy has sent three ships, including an aircraft carrier and a hospital ship to the region as well.

Catholic Relief Services, a charity active in Haiti, reported flooding and toppled trees in Les Cayes, where it has an office.

Chris Bessey, the CRS country representative based in Port-au-Prince, said the storm blew part of the roof off the charity’s two-story building in Les Cayes and knocked out its generator. The river there has crested, the streets are flooded and the main road to southern Haiti has been cut because a bridge was washed out at Petit-Goave, he said by telephone from Port-au-Prince.

Haitian authorities called on the peacekeepers of the U.N. Stabilization Mission in Haiti to assist in the response to the hurricane, said Ariane Quentier, a spokeswoman for the mission. But with the storm still raging, there was little they could do.

Quentier said 80 percent of the schools in the hardest-hit areas have been turned into shelters and that authorities have been trying to get people to evacuate their homes and head to those sites.

“We’re seeing enormous amounts of flooding, enormous amounts of wind damage,” John Hasse, national director for the aid organization World Vision in Haiti, said. Before Matthew made landfall, staffers had been trying to persuade people to get to safe structures, he said.

“Yet right up until the storm hit, we still heard many people saying, ‘We’re waiting on God’ and not making preparations,” Hasse said. He said the charity has warehouses stocked with blankets, tarps, water cans and hygiene kits to assist nearly 100,000 people, but “we expect it to go well over a million to even millions of people affected by this.”

Relief officials said many people rejected pleas to evacuate, fearing that they would lose their meager belongings to looters. For some, who changed their minds as the powerful storm unleashed its fury, it was now too late to help them, the officials said.

In the vast Cite Soleil slum in Port-au-Prince, 130 children were evacuated from an orphanage ahead of winds and rain that authorities feared could ravage the densely populated area of tin shanties, open sewers and canals.

As if the country did not have enough to worry about, a long-delayed presidential election is scheduled for Sunday and the government had no immediate plans to postpone it.

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