The quake followed by a tropical storm wiped out many of the sources of food and income that many depend on for survival in Haiti, already struggling with COVID-19, gang violence and assassination of its president.
Pressure for a coordinated response to Haiti's deadly weekend earthquake mounted Wednesday as more bodies were pulled from the rubble and the injured continued to arrive from remote areas in search of medical care. Aid was slowly trickling in to help the thousands who were left homeless.
Angry crowds massed at collapsed buildings, demanding tarps to create temporary shelters that were needed more than ever after Tropical Storm Grace brought heavy rain on Monday and Tuesday, compounding the impoverished Caribbean nation's misery.
One of the first food deliveries by local authorities — a couple dozen boxes of rice and pre-measured, bagged meal kits — reached a tent encampment set up in one of the poorest areas of Les Cayes, where most of the warren's one-story, cinderblock, tin-roofed homes were damaged or destroyed by Saturday's quake.
But the shipment was clearly insufficient for the hundreds who have lived under tents and tarps for five days.
“It’s not enough, but we’ll do everything we can to make sure everybody gets at least something,” said Vladimir Martino, a representative of the camp who took charge of the precious cargo for distribution.
Gerda Francoise, 24, was one of dozens who lined up in the wilting heat in hopes of receiving food. “I don’t know what I’m going to get, but I need something to take back to my tent,” said Francoise. “I have a child.”
On Tuesday night, Haiti’s Civil Protection Agency put the number of deaths from Saturday’s earthquake at 1,941. It also said 9,900 were injured, many of whom waited for hours outside in the stifling heat for medical assistance.
Foreign aid was arriving, but slowly. U.S. Coast Guard helicopter crews concentrated on the most urgent task, ferrying the injured to less-stressed medical facilities. A U.S. Navy amphibious warship, the USS Arlington, was expected to head for Haiti on Wednesday with a surgical team and landing craft.
Volunteers found the body of a man in the rubble of a collapsed apartment building in Les Cayes, where the stench of death hung in the tropical heat.
Officials said the magnitude 7.2 earthquake destroyed more than 7,000 homes and damaged nearly 5,000, leaving about 30,000 families homeless. Hospitals, schools, offices and churches also were demolished or badly damaged.
The quake wiped out many of the sources of food and income that many of the poor depend on for survival in Haiti, which is already struggling with the coronavirus, gang violence and the July 7 assassination of President Jovenel Moïse.
“We don’t have anything. Even the (farm) animals are gone. They were killed by the rockslides,” said Elize Civil, 30, a farmer in the village of Fleurant, near the quake’s epicenter.
Civil's village and many of those in the hard-hit Nippes province depend on livestock such as goats, cows and chickens for much of their income, said Christy Delafield, who works with the U.S.-based relief organization Mercy Corps. The group is considering cash distributions to allow residents to continue buying local products from small local businesses that are vital to their communities.
Large-scale aid has not yet reached many areas, and one dilemma for donors is that pouring huge amounts of staple foods purchased abroad could, in the long run, hurt local producers.
“We don’t want to flood the area with a lot of products coming in from off the island,” Delafield said. She said aid efforts must also take a longer view for areas like Nippes, which has been hit in recent years by ever-stronger cyclical droughts and soil erosion. Support for adapting farming practices to the new climate reality — with less reliable rainfall and more tropical storms — is vital, she said.
“The drought, followed by the earthquake, followed by the storm has caused the soil to be stripped,” Delafield said.
At the public hospital in L’Asile, deep in a remote stretch of countryside in the southwest, people were arriving from isolated villages with broken arms and legs.
Hospital director Sonel Fevry said five such patients showed up Tuesday. Grinding poverty, poor roads and faith in natural medicine worsen the problems.
“We do what we can, remove the necrotized tissue and give them antibiotics and try to get them a splint,” Fevry said, adding that access to the facility by road is difficult and not everyone can make it.
Mercy Corps said about half of L'Asile's homes were destroyed and 90% were affected in some way. Most public buildings where people would normally shelter also were destroyed.
The obstetrics, pediatric and operating wing at the L’Asile hospital collapsed, though everyone made it out. Despite the damage, the hospital was able to treat about 170 severely injured quake victims in improvised tents set up on the grounds of the facility.
The nearby countryside was devastated: In one 10-mile (16-kilometer) stretch, not a single house, church, store or school was left standing.
The U.S. Geological Survey said a preliminary analysis of satellite imagery after the earthquake “revealed at least 150 landslides west of the town of L’Asile in Département des Nippes and hundreds of landslides in the mountains and south of Beaumont in Department de la Grand’Anse.”
Dr. Barth Green, President and co-founder of Project Medishare, an organization that has worked in Haiti since 1994 to improve health services, said among the most pressing needs was medical infrastructure.
“The hospitals are all broken and collapsed, the operating rooms aren’t functional, and then if you bring tents, it’s hurricane season, they can blow right away,” Green said. He was hopeful the U.S. military would establish a field hospital in the affected area.
He said the interim Haitian government was communicating well with them, “but there’s no doubt that they’re finding their way too.”
"We have hundreds of medical volunteers, but the Haitian government tells us they don’t need them. But we’re still deploying along with other organizations,” said Green, who is also the executive dean of Global Health and Community Service at the University of Miami. He sensed caution on the part of the government after bad experiences with outside aid following previous disasters.
Etzer Emile, a Haitian economist and professor at Quisqueya University, a private institution in the capital of Port-au-Prince, said the disaster will increase Haitians' dependence on remittances from abroad and assistance from international nongovernmental groups, likely making the country even weaker.
“Foreign aid unfortunately never helps in the long term," he said. “The southwest needs instead activities that can boost economic capacity for jobs and better social conditions.”