A massive international air and sea lift of aid to earthquake-devastated Haiti was struggling last night to overcome obstacles in delivering rescue teams and emergency help to the more than 2 million people in need of immediate assistance.
Confronted by bottlenecks caused by wrecked runways, port facilities and roads, aid experts were warning it could be days before the relief effort gets fully under way, even as thousands of people remained unaccounted for beneath the rubble of Tuesday's quake and bodies were piled in the ruined streets.
The Red Cross estimated 45,000-50,000 people were killed in the magnitude 7.0 earthquake. Last night Haiti's president, René Préval, said: "We have already buried 7,000 people in a mass grave."
Aid agencies fear the crucial 72-hour window to find survivors would be missed if the help did not start getting through. Compounding the desperate problems, America's civil aviation authority was forced to halt planes leaving the US for Haiti at the request of the Haitian government because there was no more room for them to land and no fuel for the planes to return.
US officials said Port-au-Prince's airport was saturated and ground staff could not unload and move supplies into surrounding areas quickly enough to open up more space at the airport.
Among those unable to land yesterday was a team of 35 British rescue workers, including firefighters and doctors from Manchester and Lincolnshire, who spent 30 minutes circling above Port-au-Prince airport and were forced to turn back after they were running out of fuel.
Eyewitness accounts from Haiti described bodies decomposing in the streets, while the few hospitals not destroyed were overwhelmed with casualties. Others described whole neighbourhoods destroyed. "Many roads are blocked by fallen buildings. Many people walking around with open and serious wounds," said Port-au-Prince resident Tara Livesay on her blog.
"The deceased are being dragged to the side of roads, covered in sheets and left. We don't live in the hardest hit areas but even so there are many bodies."
As a sense of crisis grew over the slow speed of the emergency response, Elisabeth Byrs of the UN's office for the coordination of humanitarian affairs, said: "The priority is to find survivors. We are working against the clock."
The problems confronting the emergency efforts were disclosed even as Barack Obama appealed to his immediate predecessors, George Bush and Bill Clinton, to help co-ordinate the US efforts to help Haiti, in what Obama described as "one of the largest relief efforts in our recent history".
His comments came as he ordered the deployment of thousands of troops and civilian aid workers and promised $100m in relief funds. "To the people of Haiti, we say clearly and with conviction, you will not be forsaken, you will not be forgotten," he said.
The US army and marines are sending some 5,500 troops while more than six US military ships are being sent, including the aircraft carrier USS Carl Vinson. Britain, which has also promised £6m in immediate aid, was among a host of countries pledging to send assistance, including China, France, Mexico and Australia.
One of the most pressing problems the effort will have to overcome is the damage to the docks.
"The derricks at the port, which would be our preferred route to deliver food, are too badly damaged to be operable," said Gregory Barrow of the World Food Programme, which is appealing to donors for 14m ration packs that can be eaten without cooking – enough to feed 2 million people for a month. "Many of the people we need to feed have no cooking utensils or kitchens which is why the rations are urgently required."
At the airport, the main concourse was hit by the earthquake with the number of working runways reduced from three to one. In addition there has been a shortage of heavy lifting equipment suitable to unload most non-military kinds of aircraft quickly, while damage to the control tower has also limited the types of aircraft that could land.
"The airport is only really open to aircraft that have their own heavy lift," said Ian Bray of Oxfam, whose offices in Port-au-Prince were destroyed with the loss of one of their staff. "There is a bottleneck. We have staff in Miami and Dominican Republic we are still trying to deploy into the country. Another of the problems we are facing is the lack of effective communications with Haiti which affects how quickly we can make decisions about what we should be sending and to where."
A further problem reported by aid agencies was that many of their staff were looking for their own families. "Many of our own staff are still looking for their own families," said Harjeet Singh, head of emergencies for Americas for ActionAid. "It is completely normal and very human. But it does mean that any work, even an initial assessment of what needs to be done, is going to be difficult."
The road route from the Dominican Republic was also proving problematic, with a key bridge damaged preventing large convoys from crossing.
Alejandro Lopez-Chicheri of the WFP, who arrived in Port-au-Prince yesterday, as the organisation began distributing food at hospitals, gave a devastating depiction of the aftermath. "It is very difficult," he told the Guardian yesterday. "Many people are sleeping outside. Many people are sleeping at the stadium and in the parks. They are afraid of secondary shocks.
"We are setting up in several parts of Port-au-Prince. There are aircraft coming in. I have seen some. But for now we are focusing on the hospitals – feeding the sick and the most badly injured who need it most.
"In the city I've seen neighbourhoods that are totally destroyed. There is a problem with water. I'm hearing reports of scores of thousands dead."
Jimitre Coquillon, a doctor's assistant working at a triage centre set up in a hotel parking lot told the Associated Press: "This is much worse than a hurricane. There's no water. There's nothing. Thirsty people are going to die."
