Jeremie, Haiti (CNN) The World Health Organization is sending a million cholera vaccine doses to Haiti, it announced Tuesday, amid concerns over the rising number of cases in the aftermath of Hurricane Matthew.

WHO cholera expert Dominique Legros told reporters in Geneva that the UN's global public health body had decided Monday to send the vaccines to the hurricane-ravaged Caribbean nation, to attempt to prevent an outbreak of the waterborne disease.

Hurricane Matthew wrought devastation as it made landfall in Haiti with 145 mile-per-hour (233 kph) winds a week ago, killing hundreds, displacing thousands, destroying homes and causing widespread flooding across the impoverished nation.

Legros said the flooding created a risk of "potential contamination of the drinking water by fecal sludge," leading to concerns about the "risk of further increase of cholera cases, particularly at that time of the year where over the last few years we have observed that there is a usual increase in cases reported between November and January."

Haiti's interim President Jocelerme Privert told CNN Monday that the hurricane had accelerated the existing epidemic and undermined the strides made in fighting the disease.

"A lot of effort has been made to avoid the spread of this epidemic," he said. "But the hurricane has accelerated it."

Legros said the vaccines could cover 500,000 or a million people, depending on whether health officials opted for a "classic" two-dose strategy, or a single dose campaign, which would be easier to implement and would cover more people.

"The top priority clearly for those people affected by the hurricane is to give them access to safe water, that is the only way we can control cholera in the long term in Haiti," he said. Widespread damage to healthcare facilities in the hurricane-affected areas would also complicate efforts to treat cholera patients.

Cholera, which is spread through water or food contaminated with Vibrio cholerae bacteria, can cause severe diarrhea and vomiting, which leads to extreme dehydration. It can swiftly result in outbreaks, and patients who are not treated quickly can die within hours.

Before the hurricane, only 1 in 3 people in Haiti had access to proper latrines and less than 3 in 5 had access to safe water. In rural areas, these rates go down to 1 in 4 for sanitation and 1 in 2 for water. Diarrhea is one of the main killers of children under 5 in the country, UNICEF said.

The uptick in cholera cases, confirmed and suspected, has been most apparent in the departments of Sud and Grand'Anse, on the southwestern tip of the country, according to the Red Cross.

Rene Domersant, Health Ministry representative at Haiti's National Emergency Center, told CNN there are currently 128 confirmed cases of cholera and at least 160 suspected cases in the departments of Sud, Grand'Anse and Nippes, which borders the former two.

The medical director of Haiti Air Ambulance, Dr. Vince DeGennaro, said there was "near total destruction" of towns he had visited by air along the southwest coast, and people were left with no option but to sleep outside.

In those conditions, he said, the threat of cholera was a "huge concern."

In Saint-Antoine Hospital in the devastated coastal city of Jeremie, in Grand'Anse, there were 43 suspected cases of cholera since the hurricane hit, hospital director Conception Panfillo told CNN's Ivan Watson Monday.

Conditions were poor at the hospital, which was badly damaged by the storm. More than 450 patients had arrived over the weekend, mostly people who had been wounded by flying debris, but the hospital had run out of anesthetics and antibiotics to treat them.

"We see a lot of helicopters and planes," Panfillo said. "But we haven't gotten any aid."

CNN spoke to Angela Joseph, one of several women trying to scrub their clothes clean in the potentially contaminated waters of the Grande-Anse River, which flanks the city.

Hurricane Matthew created a huge storm surge that swept through the area, killing her chickens and goats and leaving her and her three children with nothing to eat.

"I haven't eaten all day," she told CNN's Ivan Watson, as she washed clothes in a plastic bin.

Now the threat of cholera has made access to drinking water a problem too.

"Some people came and told us not to drink water from the river because of the cholera," Joseph said, adding that she would buy small plastic bags of drinking water when she could afford it.

'Nobody has to die' from cholera

WHO spokesman Christian Lindmeier said an exact number of cholera cases across Haiti is hard to estimate. Some cases can be mild, but when treatment is not available, the loss of fluids through diarrhea and vomiting can lead to rapid dehydration and shock.

"Cholera is a disease nobody has to die from. Eighty percent of people infected will only show mild symptoms, and it can be easily treated if people are properly hydrated," Lindmeier said.

The WHO warns that rebuilding health facilities is also a priority. Once the rainy season reaches Haiti in November, cases of cholera could rise even more steeply.

Despite the rise in the reported cases, Nadesha Mijoba, country director for Haitian Health Foundation, is hopeful that Haiti is better prepared than it was when the devastating earthquake struck six years ago.

"There is more awareness about cholera in Haiti today. Medical teams are trained on how to treat and identify the problem. In 2010, the Haitian people did not know what to do," she said.</s>Less than a week since Hurricane Matthew slammed into Haiti, killing at least 1,000 people according to a tally of numbers from local officials, devastated corners of the country are facing a public health crisis as cholera gallops through rural communities lacking clean water, food and shelter.

Reuters visited the Port-a-Piment hospital early on Sunday morning, the first day southwestern Haiti's main coastal road had become semi-navigable by car.

At that time, there were 39 cases of cholera, according to Missole Antoine, the hospital's medical director. By the early afternoon, there were nearly 60, and four people had died of the waterborne illness.

"That number is going to rise," said Antoine, as she rushed between patients laid out on the hospital floor.

Although there were 13 cases of cholera before Matthew hit, Antoine said the cases had risen drastically since the hurricane cut off the desperately poor region.

The hospital lacks an ambulance, or even a car, and Antoine said many new patients were coming from miles away, carried by family members on camp beds.

Inside the hospital, grim-faced parents cradled young children whose eyes had sunk back and were unable to prop up their own heads.

"I believe in the doctors, and also in God," said 37-year-old Roosevelt Dume, holding the head of his son, Roodly, as he tried to remain upbeat.

Out on the streets, the scene was also shocking. For miles on end, almost all the houses were reduced to little more than rubble and twisted metal. Colorful clothes were littered among the chaos.

The region's banana crop was destroyed with vast fields of plantain flattened into a leafy mush. With neither government or foreign aid arriving quickly, people relied on felled coconuts for food and water.

The stench of death, be it human or animal, was everywhere.

In the village of Labei, near Port-a-Piment, locals said the river had washed down cadavers from villages upstream. With nobody coming to move the corpses, residents used planks of driftwood to push them down the river and into the sea.

Down by the shore, the corpse of one man lay blistering in the sun. A few hundred meters to his left in a roadside gully, three dead goats stewed in the toxic slime.

"It seems to me like a nuclear bomb went off," said Paul Edouarzin, a United Nations Environmental Program employee based near Port-a-Piment.

"In terms of destruction - environmental and agricultural - I can tell you 2016 is worse than 2010," he added, referring to the devastating 2010 earthquake from which Haiti has yet to recover.

Diarrhea-stricken residents in the village of Chevalier were well aware of the nearby cholera outbreak, but had little option except to drink the brackish water from the local well that they believed was already contaminated by dead livestock.

"We have been abandoned by a government that never thinks of us," said Marie-Ange Henry, as she surveyed her smashed home.

She said Chevalier had yet to receive any aid and many, like her, were coming down with fever. Cholera, she feared, was on its way.

Pierre Moise Mongerard, a pastor, was banking on divine assistance to rescue his roofless church in the village of Torbeck. In his Sunday best - a sports coat, chinos and brown leather shoes - he joined a small choir in songs that echoed out into the surrounding rice fields.

"We hope that God gives us the possibility to rebuild the Church and help the victims here in this area," he said, before the music seized him, and he slowly joined in the chant, closing his eyes and turning his palms up toward the sky.</s>(CNN) Hurricane Matthew has left Haiti, but the danger is far from over as the number of cholera cases now is on the rise.

Haiti has been plagued with the waterborne disease since 2010, after UN soldiers accidentally brought it to the country in the aftermath of a major earthquake that year. The World Health Organization reported 80,000 cases in Haiti since the initial outbreak -- and 770 new cases per week in 2016.

Now the destruction brought by Matthew has accelerated the existing epidemic and undermined the strides made in fighting the disease, the country's leader said.

"A lot of effort has been made to avoid the spread of this epidemic," said Interim President Jocelerme Privert, "but the hurricane has accelerated it."

The Haitian Health Foundation also is worried about a potential sharp increase in cholera cases. The disease is transmitted through the ingestion of contaminated water or food carrying Vibrio cholerae bacteria. Infection leads to vomiting and diarrhea, which can kill within hours if left untreated.

Nadesha Mijoba, country director for the health foundation, said the aftermath of Hurricane Matthew will make new cases harder to detect and treat.

"Cholera never left Haiti. Cases have continued since the 2010 outbreak, but they have been manageable. With a disaster like Matthew, waters rise ... and people end up relying on polluted water sources ridden with human waste and feces, which can lead to an outbreak," Mijoba said.

The top priority is to ensure that potable water is available to people in Haiti. "Whatever technology available to treat water must reach us so that populations don't rely on bad sources. Antibiotic ointments and medicine to treat open wounds are also essential," Mijoba said.

The medical director of Haiti Air Ambulance, Dr. Vince DeGennaro, said there had been dozens of cholera deaths in the southwestern town of Port-a-Piment.

"People are just sleeping outside and that leads to all sorts of problems with disease," he said.

In those conditions, he said, the threat of cholera was a "huge concern."

Save the Children has also seen a rise in cases following Hurricane Matthew.

"The number of cases is increasing with every new report," Dr. Unni Krishnan, director of Save the Children's Emergency Health Unit in Haiti, said in a statement.

"Flooding and contaminated water caused by the storm pose a huge threat to survivors, including thousands of children. Clean water and medicine delivered to the hardest hit areas in the next 24 to 48 hours is a key priority."

'Nobody has to die' from cholera

WHO spokesman Christian Lindmeier said an exact number of cholera cases across Haiti is hard to estimate. Some cases can be mild, but when treatment is not available, the loss of fluids through diarrhea and vomiting can lead to rapid dehydration and shock.

"Cholera is a disease nobody has to die from. Eighty percent of people infected will only show mild symptoms, and it can be easily treated if people are properly hydrated," Lindmeier said.

The WHO warns that rebuilding health facilities is also a priority. Once the rainy season reaches Haiti in November, cases of cholera could rise even more steeply.

Despite the rise in the reported cases, Mijoba is hopeful that Haiti is better prepared this time.

"There is more awareness about cholera in Haiti today. Medical teams are trained on how to treat and identify the problem. In 2010, the Haitian people did not know what to do," she said.

Other illnesses might start to pick up as well, especially as mosquito populations rise again.

"Mosquito populations will increase dramatically due to the water rising," Mijoba said.

"In normal circumstances, dengue and malaria are already a problem, so the incidence of these diseases is likely to worsen."</s>Less than a week since Hurricane Matthew slammed into Haiti, killing at least 1,000 people according to a tally of numbers from local officials, devastated corners of the country are facing a public health crisis as cholera gallops through rural communities lacking clean water, food and shelter.

Reuters visited the Port-a-Piment hospital early on Sunday morning, the first day southwestern Haiti's main coastal road had become semi-navigable by car.

At that time, there were 39 cases of cholera, according to Missole Antoine, the hospital's medical director. By the early afternoon, there were nearly 60, and four people had died of the waterborne illness.

"That number is going to rise," said Antoine, as she rushed between patients laid out on the hospital floor.

Although there were 13 cases of cholera before Matthew hit, Antoine said the cases had risen drastically since the hurricane cut off the desperately poor region.

The hospital lacks an ambulance, or even a car, and Antoine said many new patients were coming from miles away, carried by family members on camp beds.

Inside the hospital, grim-faced parents cradled young children whose eyes had sunk back and were unable to prop up their own heads.

"I believe in the doctors, and also in God," said 37-year-old Roosevelt Dume, holding the head of his son, Roodly, as he tried to remain upbeat.

Out on the streets, the scene was also shocking. For miles on end, almost all the houses were reduced to little more than rubble and twisted metal. Colorful clothes were littered among the chaos.

The region's banana crop was destroyed with vast fields of plantain flattened into a leafy mush. With neither government or foreign aid arriving quickly, people relied on felled coconuts for food and water.

The stench of death, be it human or animal, was everywhere.

In the village of Labei, near Port-a-Piment, locals said the river had washed down cadavers from villages upstream. With nobody coming to move the corpses, residents used planks of driftwood to push them down the river and into the sea.

Down by the shore, the corpse of one man lay blistering in the sun. A few hundred meters to his left in a roadside gully, three dead goats stewed in the toxic slime.

"It seems to me like a nuclear bomb went off," said Paul Edouarzin, a United Nations Environmental Program employee based near Port-a-Piment.

"In terms of destruction - environmental and agricultural - I can tell you 2016 is worse than 2010," he added, referring to the devastating 2010 earthquake from which Haiti has yet to recover.

Diarrhea-stricken residents in the village of Chevalier were well aware of the nearby cholera outbreak, but had little option except to drink the brackish water from the local well that they believed was already contaminated by dead livestock.

"We have been abandoned by a government that never thinks of us," said Marie-Ange Henry, as she surveyed her smashed home.

She said Chevalier had yet to receive any aid and many, like her, were coming down with fever. Cholera, she feared, was on its way.

Pierre Moise Mongerard, a pastor, was banking on divine assistance to rescue his roofless church in the village of Torbeck. In his Sunday best - a sports coat, chinos and brown leather shoes - he joined a small choir in songs that echoed out into the surrounding rice fields.

"We hope that God gives us the possibility to rebuild the Church and help the victims here in this area," he said, before the music seized him, and he slowly joined in the chant, closing his eyes and turning his palms up toward the sky.</s>(CNN) Haitians in the areas worst hit by Hurricane Matthew are desperately awaiting assistance six days after the storm, as concerns grow about potential cholera outbreaks.

Vince DeGennaro, a Port-au-Prince-based doctor who's the medical director for the country's only medical emergency helicopter program, has been flying medical relief flights into towns along Haiti's devastated southwest coast in the aftermath of the storm.

"These towns on the southwestern coast, it's near total destruction. Just about every building was knocked down, even concrete ones," he said. "It's quite frightening to see from the air ."

Towns along Haiti's southwestern coast were devastated by the hurricane.

On Sunday, he flew into the town of Roche-a-Bateau, where he said 90% of the buildings had been destroyed by the storm, including the concrete school and church buildings, leaving the residents with no shelter.

"People are just sleeping outside and that leads to all sorts of problems with disease," he told CNN.

In those conditions, he said, the threat of a cholera outbreak was a "huge concern."

The disease, which is spread through water or food contaminated Vibrio cholerae bacteria, can cause severe diarrhea and vomiting, which leads to extreme dehydration. It can swiftly result in outbreaks, and patients who are not treated quickly can die within hours.

Cholera cases have been reported in Randel, in southwestern Haiti, UNICEF reported in a situation update Monday, while DeGennaro said there had been dozens of cholera deaths in the southwestern town of Port-a-Piment.

"For cholera, every one person who has it tends to infect two or three people, so it's frightening," he said.

A cholera epidemic killed at least 10,000 people in Haiti when it was accidentally introduced by UN peacekeepers following the 2010 earthquake.

Matthew wreaked havoc as it made landfall in Haiti on Tuesday, killing hundreds, displacing thousands, destroying homes and knocking out electricity, water supply and communications in the impoverished Caribbean nation.

While international aid workers on the ground say this is the worst disaster to hit Haiti since the 2010 earthquake, it is still unclear how many people may have been killed by the Category 4 storm.

Haiti's official death toll has risen to 372, according to the country's Civil Protection Agency. However, given the strict verification process for victims, the actual numbers are likely much higher. A person is only counted as dead when their identities have been verified by the National Identification Office.

The hardest hit of Haiti's 10 regional departments, Grand-Anse, has reported even more dead than the official national toll. UNICEF said Monday that 475 people had been killed in Grand-Anse, citing local emergency operations authorities who have been tallying the dead from different cities.

DeGennaro said the mayor of Roche-a-Bateau told him that 90 people had been killed in the town alone. DeGennaro said he expected the final death toll to number in the thousands.

The UN Office for the Coordination of Humanitarian Affairs estimates 1.3 million people are living in the hardest hit areas, with 750,000 in need of immediate humanitarian assistance.

Still waiting for help

In Les Cayes, a port city in one of the worst-hit areas, residents told CNN they had yet to receive any government help in their efforts to recover from the disaster.

"I saw the water rising up to my waist. Tin roofs flying everywhere. Then a wall came down behind me," said resident Angelo Joseph as he showed the wreckage of his destroyed home to CNN.

Holly Frew, an emergency communications officer at the disaster relief organization CARE, said the damage in the city was "hard to believe, even as I see it with my own eyes."

"Matthew has uprooted massive trees and plunged them into buildings. Homes are utterly destroyed. And downed power lines litter the streets," she said.

"There are a few glimpses of life as it was -- some markets have re-opened -- but the people here have such a long road ahead."

With roads and bridges washed out, the towns in the southwest have been inaccessible by road for days, and many remained out of reach except by air, said DeGennaro.

"The first challenge has been access to some of these remote communities. We still can't reach some of the most affected areas by car," Marc Vincent, UNICEF's head of mission in Haiti, told CNN.

On the ground, medical staff were finding many patients with soft tissue injuries, lacerations and broken bones from flying debris, said DeGennaro.

Six days after the storm, the wounds were starting to develop serious infections, adding tetanus to the list of medical concerns, he said.

The priority was getting food, water and shelter to affected populations, to try to prevent outbreaks of disease compounding Haiti's misery, he said.

"I expect the cholera to increase and other illnesses related to dehydration in the short term, and malnutrition in the medium term," he said.</s>Haiti started burying some of its dead in mass graves in the wake of Hurricane Matthew, a government official said on Sunday, as cholera spread in the devastated southwest and the death toll from the storm rose to 1,000 people.

The powerful hurricane, the fiercest Caribbean storm in nearly a decade, slammed into Haiti on Tuesday, whipping it with 145 mph (233 kph) winds and torrential rains.

A Reuters tally of numbers from local officials showed that 1,000 people were killed by the storm in Haiti, the poorest country in the Americas.

The official death toll from the central civil protection agency is 336, a slower count because officials must visit each village to confirm the numbers.

Authorities had to start burying the dead in mass graves in Jeremie as the bodies were starting to decompose, Kedner Frenel, the most senior central government official in the Grand’Anse region on Haiti’s western peninsula.

Frenel said 522 people died in Grand’Anse alone. A tally of death reported by mayors from 15 of 18 municipalities in Sud Department on the south side of the peninsula showed 386 people there. In the rest of the country, 92 people died, the same tally showed.

Frenel said there was great concern about the cholera spreading, and that authorities were focused on getting water, food and medication to the thousands of people living in shelters.

Cholera causes severe diarrhea and can kill within hours if untreated. It is spread through contaminated water and has a short incubation period, which leads to rapid outbreaks.

Government teams fanned out across the hard-hit southwestern tip of the country over the weekend to repair treatment centers and reach the epicenter of one outbreak.

A small airstrip at the edge of town meanwhile hums with activity. Aid convoys are arriving from the capital, now that some roads washed out by Hurricane Matthew have been cleared. A barge carrying food and water is moored offshore.

An international response is finally getting underway as Haitian authorities try to gauge the full extent of the staggering blow delivered by Hurricane Matthew, including hundreds dead and tens of thousands of homes obliterated.

The precise death toll remained uncertain Sunday. Guillaume Silvera, a senior official with the Civil Protection Agency in the storm-blasted Grand-Anse Department, which includes Jeremie, said at least 522 deaths were confirmed there alone — not including people in several remote communities still cut off by collapsed roads and bridges.

National Civil Protection headquarters in Port-au-Prince, meanwhile, said Saturday its official count for the whole country was 336, which included 191 deaths in Grand-Anse.

Haiti began three days of formal national mourning on Sunday under a decree issued by President Jocelerme Privert, even as aid began to move toward flattened communities.

“It’s beginning to pick up now,” said Stephane Rolland, a regional coordinator for the International Federation of the Red Cross, as workers unloaded blankets, soap, bleach and other critical items in Jeremie on Saturday.

The first two cargo planes of humanitarian aid from the United States arrived on Saturday at the Toussaint Louverture airport in the capital Port of Prince. U.S. Ambassador Peter Mulrean said that three other planes are expected to arrive in the next few days with a total amount of 480 metric tons of humanitarian supplies.

There are clearly limits, though, including the fact that the airstrip in Jeremie is unable to accommodate large cargo planes, and only operates in the daytime.

Many of the villages in the southwestern peninsula are difficult to reach. And people are growing increasingly desperate after losing everything when the storm ripped through the area on Tuesday.

Dony St. Germain, an official with El Shaddai Ministries International, said young men in villages off the road between the southern city of Les Cayes and Jeremie were starting to put up blockades of rocks and broken branches to halt the convoys.

“They are seeing these convoys coming through with supplies and they aren’t stopping. They are hungry and thirsty and some are getting angry,” said St. Germain.

Government officials estimate that at least 350,000 people need assistance, and concern was growing over an increase in cholera cases following widespread flooding unleashed by Matthew. An ongoing cholera outbreak has 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.

Maria Sofia Sanon, 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, and a group of young mothers sat outside holding up the arms of their glassy-eyed children being rehydrated via IVs.

“They’re not supposed to be in the sun, but we have no more beds,” Sanon said.

The World Food Program says there has been massive destruction of crops. Hospitals and clinics have been damaged or destroyed as they struggle to deal with an increase in patients with injuries sustained during the storm as well as an apparent increase in cholera. UNICEF said that in Grand Anse alone there were 66,000 houses destroyed and 20,000 heavily damaged.

“Information gathered from various sources in the field suggests that the human toll (dead and injured) will be heavier than the current official figures,” the agency said in a report.

Jocelyne Saint Preux was part of the crowd that lined up in an orderly fashion to get food as aid began to arrive, including shipments of food and other emergency supplies from the U.S. Agency for International Development carried by waves of military transport helicopters.

The mother of three children whose home was destroyed said officials were handing out wheat, beans, oil and salt.

“Yes, they brought food, but it’s not sufficient,” she said. “There’s no water. There’s no charcoal.”

As aid trickled into 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 her belongings 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.

Haiti faces a growing cholera outbreak that threatens to turn its disaster even more deadly.

In Port Salut, a smashed-up town on Haiti’s southern peninsula that was among those that bore the brunt of Hurricane Matthew, fears are rising.

The town’s sole hospital on Sunday recorded its first death from the disease, a man of undisclosed age.

Another nine patients brought in within the past two days are being treated for the illness, which is caught from contaminated water.

Other cholera deaths have been reported in different parts of southern Haiti.

The outbreak is especially alarming for this destitute tropical nation. In the wake of a catastrophic earthquake in 2010, cholera was inadvertently introduced by U.N. peacekeepers and went on to kill around 10,000 people.

Civil defense officials have put the death toll from the hurricane itself at 336, although some officials said it topped 400.

Dr. Stevenson Desravines, the director of the Port Salut hospital, told AFP that cholera was rapidly becoming a “fatal danger” for the town and surrounding area.

“It’s something that is starting,” he said, adding that his facility lacked personnel, medicine and equipment to tackle that and other health problems.

“Since the storm, we are receiving around 100 patients a day, with 85 percent from storm-related injuries,” mainly broken bones, bleeding and concussions from falling trees, roofs and other objects, he said.

The remainder had other, regular illnesses such as asthma and high blood pressure.

Before the cholera death, the hospital had registered three patients deceased from their injuries sustained last Tuesday when the storm struck with tremendous fury.

The hospital, standing intact on a street of destroyed and damaged houses and fallen trees, has a staff of 55 — a third of them Cuban, who are operating under a years-old cooperation agreement.

One of the Cuban personnel, who declined to be identified because he wasn’t authorized to speak to media, said storm-related injuries were currently the health priority for his team.

There were very few cholera cases right now, relatively, he said.

But after he spoke the cholera death occurred in the hospital, galvanizing staff and focusing attention on the new threat.

AFP journalists saw the covered body of the deceased patient in a hospital room, and Desravines confirmed the death was from the disease.

Outside, sheltering in the shade from the bright sun, another cholera-afflicted patient, a weak-looking woman, received fluid intravenously.

Inside and outside the hospital, used soda bottles filled with diluted chlorine hung from handrails, encouraging staff, patients and visitors to regularly disinfect their hands to avoid catching the disease.

A sign pointed those with suspected cholera to use a separate entrance.

Desravines said that so far he had received no help from the United Nations or other aid organizations in the country.

“We are waiting for more personnel, more supplies, including intravenous bags, medicines and cleaning products,” he said.</s>Know Your Value</s>(CNN) Haitians in the areas worst hit by Hurricane Matthew are desperately awaiting assistance six days after the storm, as concerns grow about potential cholera outbreaks.

Vince DeGennaro, a Port-au-Prince-based doctor who's the medical director for the country's only medical emergency helicopter program, has been flying medical relief flights into towns along Haiti's devastated southwest coast in the aftermath of the storm.

"These towns on the southwestern coast, it's near total destruction. Just about every building was knocked down, even concrete ones," he said. "It's quite frightening to see from the air ."

Towns along Haiti's southwestern coast were devastated by the hurricane.

On Sunday, he flew into the town of Roche-a-Bateau, where he said 90% of the buildings had been destroyed by the storm, including the concrete school and church buildings, leaving the residents with no shelter.

"People are just sleeping outside and that leads to all sorts of problems with disease," he told CNN.

In those conditions, he said, the threat of a cholera outbreak was a "huge concern."

The disease, which is spread through water or food contaminated Vibrio cholerae bacteria, can cause severe diarrhea and vomiting, which leads to extreme dehydration. It can swiftly result in outbreaks, and patients who are not treated quickly can die within hours.

Cholera cases have been reported in Randel, in southwestern Haiti, UNICEF reported in a situation update Monday, while DeGennaro said there had been dozens of cholera deaths in the southwestern town of Port-a-Piment.

"For cholera, every one person who has it tends to infect two or three people, so it's frightening," he said.

A cholera epidemic killed at least 10,000 people in Haiti when it was accidentally introduced by UN peacekeepers following the 2010 earthquake.

Matthew wreaked havoc as it made landfall in Haiti on Tuesday, killing hundreds, displacing thousands, destroying homes and knocking out electricity, water supply and communications in the impoverished Caribbean nation.

While international aid workers on the ground say this is the worst disaster to hit Haiti since the 2010 earthquake, it is still unclear how many people may have been killed by the Category 4 storm.

Haiti's official death toll has risen to 372, according to the country's Civil Protection Agency. However, given the strict verification process for victims, the actual numbers are likely much higher. A person is only counted as dead when their identities have been verified by the National Identification Office.

The hardest hit of Haiti's 10 regional departments, Grand-Anse, has reported even more dead than the official national toll. UNICEF said Monday that 475 people had been killed in Grand-Anse, citing local emergency operations authorities who have been tallying the dead from different cities.

DeGennaro said the mayor of Roche-a-Bateau told him that 90 people had been killed in the town alone. DeGennaro said he expected the final death toll to number in the thousands.

The UN Office for the Coordination of Humanitarian Affairs estimates 1.3 million people are living in the hardest hit areas, with 750,000 in need of immediate humanitarian assistance.

Still waiting for help

In Les Cayes, a port city in one of the worst-hit areas, residents told CNN they had yet to receive any government help in their efforts to recover from the disaster.

"I saw the water rising up to my waist. Tin roofs flying everywhere. Then a wall came down behind me," said resident Angelo Joseph as he showed the wreckage of his destroyed home to CNN.

Holly Frew, an emergency communications officer at the disaster relief organization CARE, said the damage in the city was "hard to believe, even as I see it with my own eyes."

"Matthew has uprooted massive trees and plunged them into buildings. Homes are utterly destroyed. And downed power lines litter the streets," she said.

"There are a few glimpses of life as it was -- some markets have re-opened -- but the people here have such a long road ahead."

With roads and bridges washed out, the towns in the southwest have been inaccessible by road for days, and many remained out of reach except by air, said DeGennaro.

"The first challenge has been access to some of these remote communities. We still can't reach some of the most affected areas by car," Marc Vincent, UNICEF's head of mission in Haiti, told CNN.

On the ground, medical staff were finding many patients with soft tissue injuries, lacerations and broken bones from flying debris, said DeGennaro.

Six days after the storm, the wounds were starting to develop serious infections, adding tetanus to the list of medical concerns, he said.

The priority was getting food, water and shelter to affected populations, to try to prevent outbreaks of disease compounding Haiti's misery, he said.

"I expect the cholera to increase and other illnesses related to dehydration in the short term, and malnutrition in the medium term," he said.</s>At least 473 people are now known to have died as Hurricane Matthew leveled swaths of southern Haiti last week, officials said Tuesday, as hard-hit communities struggled to rebuild homes and access food and clean water.

Haiti is observing three days of mourning for the victims of the deadly storm, which also left 75 missing and 330 injured according to the provisional toll from the nation's civil protection agency.

More than 175,500 people remain in shelters across the country, many of them in schools -- which is keeping nearly 100,000 children from resuming classes.

Matthew struck as the impoverished nation was struggling to stifle a cholera outbreak that authorities fear will now worsen, with the World Health Organization pledging Tuesday to send a million doses of the cholera vaccine.

Two water purification stations also arrived in Port-au-Prince Tuesday as part of France's first shipment of humanitarian aid, which comprised some 69 tonnes of supplies including medicine and anti-cholera kits.

But damage to roads and communications has hamstrung deliveries of supplies in some areas, according to an AFP journalist in the southern coastal village of Groteaux.

Many residents of that community were still struggling to find food and clean water as they scrambled to repair their battered homes.

Many Groteaux homes sported new tin roofs bought at inflated prices, but poorer families could not afford new metal sheets to shelter them from intense sunlight, tropical rains or bloodthirsty mosquitoes.

"Only God knows what we will eat," Jean Nelson, 68, told AFP. "We are eating only coconuts that fell."

"We don't have money for rice," he said, adding that the price of the staple has doubled in the past week.

Nelson said that even though roads are now accessible, with cell phone coverage also starting to improve, no Haitian officials or relief workers have visited the hard-hit town.

The UN envoy Sandra Honore urged the Security Council on Tuesday to keep UN peacekeeping forces in Haiti for another six months to help cope with storm damage, ahead of a vote on renewing the mission's mandate.

The world body's chief Ban Ki-moon said a massive international response was needed to help Haiti as the United Nations launched a $120 million flash appeal for the next three months. AFP</s>At least 1.4 million need aid in Haiti after Matthew: UN

Haiti faces a humanitarian crisis that requires a “massive response” from the international community, the United Nations chief said Monday, with at least 1.4 million people needing emergency aid following last week’s battering by Hurricane Matthew.

The storm left at least 372 dead in the impoverished Caribbean nation, with the toll likely to rise sharply as rescue workers reach previously inaccessible areas.

Matthew leveled homes, fouled water sources and killed livestock, with victims pleading for help to arrive quickly.

The United Nations has launched a $120 million flash appeal to cover Haiti’s needs for the next three months.

“Some towns and villages have been almost wiped off the map,” he said.

“These numbers and needs are growing as more affected areas are reached.”

After pummeling Haiti on October 4 as a monster Category 4 storm, packing winds of 145 miles (230 kilometers) per hour, Matthew slammed into the southeastern United States, where it killed at least 20 people.

- Worst humanitarian crisis –

 

 In Haiti, more than 300 schools have been damaged, while crops and food reserves were destroyed, Ban said.

UN aid chief Stephen O’Brien said the hurricane had triggered the worst humanitarian crisis in the country since the 2010 earthquake.

The department of Grande Anse in Haiti’s southwest, which took a direct hit, was the most devastated area, with 198 dead, 97 injured and 99,400 people staying in temporary shelters.

More than 175,500 are in shelters elsewhere in the country.

Damage to roads and communications has hamstrung deliveries of supplies.

“I understand of course the frustration,” Jean-Luc Poncelet, the country representative for the UN’s World Health Organization, said after arriving at the airport outside Jeremie, one of the worst-hit cities.

“When you have no means of communication, no radio, no telephone, no roads and even a helicopter can’t land — this is what explains the massive delay,” he told AFP.

The UN’s World Food Programme tapped into food stocks previously set aside for schools to feed hundreds of desperate families, spokesman Alexis Masciarelli said.

Twenty-fix more tons had been moved to Jeremie for distribution, and more was on its way to Les Cayes, the other major city affected on the peninsula, he said.

American military helicopters were unloading boxes of supplies from the United States Agency for International Development to be stored by the UN in Jeremie before being taken to other parts of the south.

An official at the airport who declined to be identified said nearly 20 tons of supplies — tarpaulins, rice, cooking oil and hygiene kits — were being brought in.

That added to 47 tons already flown in on US helicopters from the capital Port-au-Prince.

Honduras, which maintains a force of 60 troops in Haiti as part of a UN peacekeeping mission, was sending a planeload of aid on Tuesday, along with 50 military officers to assist the victims, President Juan Orlando Hernandez said.

But getting aid to Haitians now reduced to drinking unclean water and living in roofless houses will be challenging.

On a road crossing the mountainous center of the peninsula, some villagers blocked roads in an effort to stop aid convoys from passing through without delivering supplies.

 

 - Cholera fears -

Haiti is also grappling with a worsening cholera outbreak in the storm-hit areas.

Matthew came as Haitians were already struggling with the intestinal disease spread by contaminated food and water, with more than 500 new cases each week.

UN peacekeepers have been blamed for introducing the disease to Haiti, where it has killed 10,000 people since October 2010.

While some towns and villages reported an apparent spike in infections since the storm, Poncelet said “the number of cases of cholera that we have confirmed are low.”

He declined to give a number, but said there were “tens” of cases in one area of the peninsula.

While evaluation teams were working to get a precise picture of the health situation, medical supplies were being brought in, he said.

Mourad Wahba, the UN humanitarian coordinator in Haiti, urged aid organizations to focus on delivering supplies to smaller rural communities, where many families survive on subsistence farming and have had all their crops washed away.

If aid is only delivered to cities such as Jeremie and Les Cayes, villages will flock there for supplies and never leave, leading to overcrowding.

“We must think about developing a plan, to coordinate support and deliver it where it’s most needed and not where it’s easiest to access,” Wahba said.
The United Nations launches an emergency appeal for almost U.S.$120 million in life-saving help for 750,000 survivors in Haiti at risk of starvation and/or cholera.