Residents of northern Grand Bahama island and the Abaco Islands have been forced to make very elemental decisions in the wake of Dorian, the most powerful hurricane on record to hit the Bahamas.

The storm swept through the islands earlier this week, levelling neighbourhoods and knocking out key infrastructure. Hundreds, if not more, are still missing in the country of about 400,000 people, and officials say the death toll, which stands at 30, is likely to shoot up as more bodies are discovered in the ruins and floodwaters left behind by the storm.

Relief groups were focusing on getting doctors, nurses and medical supplies into the hardest-hit areas and helping survivors get food and safe drinking water.

Abaco resident Jerrod Green is among those who would welcome aid. He told CBC News he’s depended on the kindness of his boss, who’s shared supplies and food with some of his workers.

“There’s no power, there’s no water,” he said. “So you got nothing else. But you know, I’m just hoping that someone will come along and help us.”

The Bahamian Health Ministry said helicopters and boats were on the way to help people in affected areas, though officials warned of delays because of severe flooding and limited access.

Residents and visitors hope to catch a flight from the island devastated by Hurricane Dorian at the airport in Treasure Cay, Abaco, Bahamas, September 5, 2019. Picture taken on September 5, 2019. REUTERS/Aleksandra Michalska – RC183214D230 (REUTERS)

Unprecedented storm

Francesca Newbold, who’s lived on the Abaco Islands for several years, was still in disbelief over the force of Dorian, which hammered the northern Bahamas with winds up to 295 km/h.

“I’ve been through hurricanes but nothing, nothing like this ever in my life,” said Newbold.

The storm levelled her residence and furniture but she and her husband managed to find many of their possessions.

“You need laundering and stuff but we still have our things to live with,” she said.

They plan to wait it out, come what may.

“Abaconians are pretty strong,” she said. “Some are leaving and saying they’re not coming back, but my husband is staying and the people down [the road] are staying.”

Watch: Steven D’Souza talks with Abaco resident Francesca Newbold

Abaco Island residents wait patiently for aid. 0:44

Holding out hope 

Many residents will need that strength, according to the Pan American Health Organization, which described the situation for some as “desperate.” The risk of outbreaks of diarrhea and waterborne diseases is high because drinking water may be contaminated with sewage, the health agency said.

The United Nations estimated 70,000 people were in immediate need of food, water and shelter on the islands. 

Tevya Friedman from the Seattle-based urban search and rescue group Empact Northwest told CBC News that time is of the essence when looking for survivors.

“Studies show we have up to seven days, survivability is still [possible] up to seven days,” he said.

Friedman said that even with the full support of the Bahamas’ National Emergency Management Agency (NEMA), the task is daunting, with logistical challenges including downed communication systems and where to find runway space.

“It’s a lot of moving pieces, it takes us a while to move from place to place,” he said of his 16-member team, which had hoped to embark on three rescue flights on Friday.

Watch: The challenges for search and rescue operations

CBC’s Steven D’Souza spoke with Tevya Friedman from urban search and rescue group Empact Northwest. 2:07

Others were beyond saving, according to witnesses. The expectation from officials is that the death toll will climb significantly.

“You smell the decomposing bodies as you walk through Marsh Harbour,” said Sandra Sweeting, 37, in an interview with Reuters amid the wreckage on Great Abaco Island. “It’s everywhere. There are a lot of people who aren’t going to make it off this island.”

Those who planned to leave — to find work, child care and medical services — included residents whose houses survived.

“There is simply nothing left there,” said Anita Pinder, a 38-year-old mother of two, told Reuters. “It has vanished. It’s just rubble.”

Others got a head start. With a few meagre possessions stuffed in plastic bags, many Bahamians waited at the small airport in Treasure Cay, a sliver of land connected to Great Abaco which was known for its resort, now in ruins,

Some of the waiting masses were promised a departure on Bahamasair, others on relief flights from volunteer groups or charters. Some were simply at the airport without a plan, hoping to find a ride to Nassau or the United States, and still others were there seeking supplies.

This week, Hurricane Dorian delivered catastrophic damage to the Bahamas. It was a Category 5 storm when it hit the island nation, with winds of up to 295 km/hr, and Prime Minister Hubert Minnis said it left “generational devastation.” Today on Front Burner, in the age of intensifying storms, two very different portraits of hurricane recovery. Janise Elie of the Guardian describes the devastation of the Caribbean Island of Dominica by Hurricane Maria in 2017. Then, Rice University assistant professor Max Besbris talks about how Houston, Texas rebuilt after Hurricane Harvey that same year. 24:26

The Treasure Cay airport has no lights, so planes cannot take off after sunset. Crowds began to gather by the runway as early as 4 a.m on Friday, a mix of those unable to catch a flight the previous day, as well as a new crop of evacuees.

Around 250 evacuees arrived in Nassau, the capital, by boat on Friday afternoon, and a further 250 were expected later in the day, the National Voice of the Bahamas radio station reported, citing a NEMA spokesperson.

Mental health a concern

Survivors will also grapple with the emotional trauma triggered by the horrors of the preceding days, experts say.

The Caribbean Development Bank (CDB), which helps Caribbean nations finance social and economic programs, said this week it would provide almost $1 million in relief funds to the Bahamas. That’s in addition to the traditional financial assistance it offers in the wake of such storms.

“Mental health is a new area for [the bank] and it has come out from close work with other countries in the region that have experienced natural disasters,” its president William Warren Smith told the Thomson Reuters Foundation on Friday in a phone interview.

“The ferociousness of these events has a major impact on people, not only on their day-to-day life but also their psychological conditions,” he said.

On a flight to Nassau, which included three Reuters reporters, 22-year-old Paul Manochka worried about the future.

“Nassau is so small, so overpopulated already, I don’t know if we’ll find anything,” Manochka said.

“We might have to go to another island, but there are no jobs on the other islands.”