Hurricane Dorian finally edged away from the Bahamas, leaving a trail of destruction that has cut off access to much of Grand Bahama and Abaco islands, but several relief organizations say they have touched ground and started offering aid.
At least 20 deaths were attributed to Dorian as it battered the Bahamas for several days with winds up to 185 mph and torrential rain, but the number was expected to rise as rescue operations continued, said Bahamas Health Minister Duane Sands.
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“We are in the midst of one of the greatest national crises in our country’s history,” said Bahamian Prime Minister Hubert Minnis. "It is going to require a massive coordinated effort to rebuild."
That effort will likely be hindered by submerged passageways and damaged ports.
Humanitarian aid organization, Direct Relief, dispatched a small team by chartered flight Monday to begin assessment and administer an initial medical response, which is the country’s most pressing concern, said Andrew MacCalla, vice president of emergency response for the organization.
“The things people need very quickly are medicines for chronic illness like diabetes, asthma and hypertension that were wiped out in the hurricane,” he said.
Initial assessments show that nearly 75,000 people may be in need of medical aid, he said.
The group brought in pre-relief packages that included 250 items that would accommodate 1,000 people for one week, but several challenges remain, he said.
“There is a lack of information on what exactly is needed right now. We have supplies based on our estimates and projections, but we need more information,” he said, adding that he expects conditions to worsen in coming days as people become more sick, hungry and thirsty.
Dorian wiped out much of the island’s water supply, leaving 62,000 people on Abaco and Grand Bahama islands without clean water, according to the International Red Cross.
Direct Relief is also using drones to help deliver supplies as access remains limited, MaCalla said.
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AmeriCares, a nonprofit relief organization, also launched a medical response effort after arriving Wednesday.
"The needs are great," said Kate Dischino, vice president of emergency programs for Americares. “Health facilities are dealing with lack of communication and electricity.”
The group is trying to support medical facilities that have been serving as shelters and that have had an influx of people with acute issues and major trauma, such as amputations, she said.
U.S. Customs and Border Protection’s Air and Marine Operations were among the agencies responding to the tragedy in the Bahamas. The U.S. Coast Guard is also deployed and as of Wednesday afternoon, its crews had rescued 114 people and six pets, it said in a statement.
Jim Bell told NBC News on Wednesday that after storm hit the Abaco Islands with 185 mph winds, "the house landed on top of me."
He said he was trapped and on the floor for around two hours until he was able to get one arm out and eventually crawl to a shed.
"I'm banged up, but I'm all right," Bell, of Delray Beach, Florida, said. He said of the sight of a U.S. helicopter Wednesday, "God bless Americans. That’s all I can say, man."
“I thought I was going to die,” Bell, who said he has stage 4 cancer, said of the ordeal. “I was an hour-and-half, two hours in that rubble, in 185 [winds]. And I crawled out.”
Donnie Carey, 75, said there was a storm surge that he estimated at around 25 feet and he and his wife fled to a friend’s home. Without that refuge, he said they would have certainly drowned.
"I'll tell you, it was something else. I thought Floyd was bad," said Carey, referring to the 1999 hurricane.
“This thing, when it hit, the waves are busting in the bottom of the house and then the roof started to peel off,” he said. "It was unbelievable."
Carrey grew up in the Bahamas capital of Nassau and does not plan to leave.
World Central Kitchen, a relief organization founded by chef José Andres that provides meals after natural disasters, landed in Nassau by helicopter on Friday as Dorian lingered over the island.
“We got a kitchen set up and ready to respond and started delivering meals for folks in clinics and shelters around the island right away,” said Nate Mook, World Central Kitchen executive director. “But the logistics are really unlike anything we’ve experienced before.”
Instead of bringing in their own food, which would take a long time to continuously ship to the island, the organization began using local sources for groceries and supplies to start as quickly as possible, he said.
"Real Housewives of New York" star Bethenny Frankel traveled to the Bahamas on Monday with her organization B Strong on a plane filled with donated supplies.
Frankel described entry into the island as “extremely difficult” because many of the ground ports were destroyed.
She was stunned to see what the was left of the country.
“It’s complete destruction, this is beyond a catastrophe. I’ve never seen anything like it,” she said from the Bahamas.
Frankel said her organization is collecting donations that are being stored at a warehouse in Miami and will be brought into the island as access continues to open up.
She said the items most needed were medical supplies, generators and chainsaws to help people get out of trapped areas.
Frankel, who initiated private aid efforts in hurricanes Maria and Irma in 2017, said the first phase is usually the most chaotic, but several relief organization have begun to trickle in and coordinate with one another.
“People need to now understand that is a really bad situation,” she said. “This is not crying wolf, this is the wolf and we’ve got a long way to go.”
Safia Samee Ali
Safia Samee Ali writes for NBC News, based in Chicago.