The most powerful Caribbean hurricane in nearly a decade has hit Haiti, bringing 230km/h (145mph) winds, heavy rain and dangerous storm surges.
Hurricane Matthew, a Category Four storm, swept over the west of Haiti and is now close to eastern Cuba.
Southern Haiti has effectively been cut off after the bridge linking it to the capital, Port-au-Prince, collapsed.
The deputy mayor of the southern coastal town of Les Cayes described the scene there as “catastrophic”.
Marie Claudette Regis Delerme said the city of 70,000 people was flooded and many houses had lost roofs. She herself had to flee a meeting when a gust ripped off the building’s roof.
One man too ill to leave his home was killed when waves struck in the town of Port Salut.
Haiti’s Interim President Jocelerme Privert said earlier that some people at sea or who had not “respected alerts” had died, but he gave no more details.
Four people died after mudslides and wall collapses in neighbouring Dominican Republic.
Officials said they were trying to restore access to Haiti’s southern peninsula after the collapse of the La Digue bridge but admitted it would be difficult to find an alternative route.
Haiti is one of the world’s poorest countries and many of its 11 million residents live in areas prone to flooding and in flimsy housing. Matthew was expected to bring up to 102cm (40in) of rain to some parts as it moves north at about 15km/h.
Images from Les Cayes showed people walking in water shoulder high, with relief workers saying that other coastal communities were also under water, including Les Anglais.
Fonie Pierre, director of Catholic Relief Services for Les Cayes, told AP: “Many people are now asking for help, but it’s too late because there is no way to go evacuate them.”
Haiti has been taking a brutal pounding. The conditions here are atrocious – to step outside is to be drenched within seconds.
Most vulnerable have been those who inhabit the shacks along the western coastline. There, storm surges are the main danger.
People here are confronting life-threatening flooding and the likelihood of mudslides in a landscape denuded of trees.
This Category Four storm comes as this impoverished country is still recovering from the 2010 earthquake which killed more than 200,000 people, and a cholera epidemic that followed.
Many live in shanty towns that offer little protection from the high winds and rains. And many refused to evacuate, fearing that what few possessions they have left would be stolen.
The mayor of Tiburon, Remiza Denize, spoke of large waves hitting the town: “Everyone is trying to find a safe place to protect themselves.”
Marie Alta Jean-Baptiste, director of the country’s Civil Protection Agency, said that there had been a major landslide between Les Cayes and Tiburon.
A farmer in the town of Leogane, Milriste Nelson, said: “All the banana trees, all the mangoes, everything is gone.”
Guantanamo Bay evacuation
Haitian officials say that about 1,300 emergency shelters have been built, enough to accommodate 340,000 people. Both airports in Haiti are closed.
One local in Port-au-Prince said the community would unite in the face of the storm’s danger.
“We are communicating amongst ourselves thanks to our own means. We will tell the people how the situation is. If things are bad then we will come together.”
Unicef said more than four million children might be exposed to hurricane damage.
The UN children’s fund representative in Haiti, Marc Vincent, said: “Waterborne diseases are the first threat to children in similar situations – our first priority is to make sure children have enough safe water.”