Survivors of the powerful earthquake that shook Haiti scrambled for shelter, food and medical supplies Wednesday as officials acknowledged that the deadly temblor had disrupted vaccination efforts. The aftermath of Tropical Storm Grace continued to snarl already feeble relief efforts, worsening a dire humanitarian crisis and fueling anger.

Heavy rainfall from the storm Tuesday battered temporary shelters set up since the weekend, drenching people stranded by Saturday’s 7.2-magnitude earthquake. Some slept out in the open. And while the sun was out Wednesday, flooding and mudslides cut off roads, blocking urgently needed aid deliveries and stalling efforts to search for those still missing or trapped beneath the rubble.

Hospitals in the Tiburon Peninsula were overwhelmed, struggling to secure sufficient medical supplies, including anesthetics, and to find enough staff members to treat the badly injured. At least 24 health-care facilities were damaged, including several that were destroyed. Other hospitals were effectively rendered “nonfunctional,” USAID said, because they lacked adequate access to electricity and water.

Haiti’s health ministry urged residents to donate blood. Didier Hérold Louis, the head of Haiti’s national ambulance center, told Haitian radio station Magik9 on Wednesday that it had been inundated with calls, but lacked nurses, drivers and first aid workers.

“There’s no doubt, we are facing a big humanitarian emergency,” Prime Minister Ariel Henry said in a Wednesday evening address. “The country of all of us, Haiti, is on his knees. This earthquake proves once again our limits and how fragile we are.”

Carissa Etienne, director of the Pan American Health Organization, said the needs in Haiti are “immense.” She said there remained logistical challenges, and a lack of clean drinking water and sanitation increased the risk of diarrhea, respiratory illnesses and skin diseases.

“The earthquake aftermath, combined with the covid-19 pandemic, presents a very challenging situation for the people of Haiti,” Etienne said.

Saturday’s quake disrupted vaccination efforts in Haiti, where doses are limited and just 0.17 percent of the population of more than 11 million have received at least one jab, according to Oxford University’s Our World in Data.

Ciro Ugarte, director of health emergencies for the Pan American Health Organization, said vaccination efforts had been accelerating in recent weeks. Then the earthquake hit, disrupting the rollout.

“Understandably, the priority of the health personnel and health authorities is to save lives and reduce the impact of the earthquake in many areas,” Ugarte said, “and also, a lot of health-care workers are overwhelmed treating trauma patients … but also treating other diseases and trying to reestablish the health services that have been impacted by the earthquake.”

The death toll Wednesday rose sharply to 2,189, almost 250 more than Tuesday’s figure. More than 12,000 people were injured, according to Haiti’s civil protection agency.

The earthquake compounded woes in the Western Hemisphere’s poorest nation, which was already struggling with a coronavirus outbreak and a scarce vaccine supply, gang violence that aid agencies have warned is threatening to imperil relief efforts, and political turmoil that was deepened by the assassination of President Jovenel Moïse last month.

U.S. national security adviser Jake Sullivan told reporters Tuesday that it was “too early to tell” what impact the earthquake would have on the political disorder in the Caribbean nation. He said there were no plans to send U.S. military personnel to the country.

Residents of Les Cayes prepared to weather Tropical Storm Grace on Aug. 16 after a 7.2 earthquake destroyed homes and devastated the country. (Yvon Vilius, Joshua Carroll/The Washington Post)

UNICEF has estimated that the earthquake affected about 1.2 million people, including 540,000 children, and damaged or leveled some 84,000 homes. Among those searching for survivors was a 10-year-old boy who pulled three of his aunts from the rubble, the organization said.

Bruno Maes, UNICEF’s representative in Haiti, said 20 schools in one of the country’s administrative regions were reduced to rubble, while 74 others were partially destroyed. He tweeted photos of school desks covered in debris and gaping holes in classroom walls mere weeks before the start of the school year.

“Countless Haitian families who have lost everything due to the earthquake are now living literally with their feet in the water due to the flooding,” he tweeted with a video of a flooded street.

UNICEF estimated that $15 million is needed to respond to the most urgent needs.

U.N. Secretary General António Guterres said Tuesday the United Nations set aside $8 million in emergency funds for health care, water and shelter in the country. He called for countries to step up foreign aid to prevent a “humanitarian disaster.”

In L’Asile, a town in the remote region of Nippes near the earthquake’s epicenter, roughly 90 percent of homes were affected by the quake and about half were reduced to rubble, according to Christy Delafield, a spokeswoman for Mercy Corps who visited the area, at times driving with her team through a foot of water.

Among the challenges, she said, is that the roads leading into the area cannot support large trucks, meaning several smaller vehicles would be needed to shuttle supplies, and buildings such as churches and schools that might have served as shelters were also damaged.

“There was one school that we visited that was only partially destroyed, where there were about 200 people sheltering there overnight,” Delafield said, “and they said that more people are arriving each night.”

Aid was slowly trickling into the country Wednesday, but some residents were frustrated by the discrepancy between what Henry promised over the weekend would be rapid relief efforts and the reality on the ground.

Martin Coria, the regional director for Latin America and the Caribbean for the Church World Service charity, told The Washington Post that some of the areas where his teams work in Haiti have yet to receive any external aid. Mudslides and landslides, he said, had choked off many of the arteries leading to the remote towns hard-hit by the quake.

“The words that I keep hearing from my colleagues in Haiti … are that people are desperate, traumatized and shocked,” Coria said.

Haiti is still recovering from a devastating 7.0-magnitude earthquake in 2010 near the capital of Port-au-Prince that killed more than 220,000 people when Saturday’s temblor struck.

“It’s just one thing after another,” Delafield said. “Talk about the number of shocks and stresses that Haiti has been though. … It’s devastating and incredibly hard.”

Anthony Faiola in Port-au-Prince, Haiti, contributed to this report.

Read more: