PORT-AU-PRINCE, Haiti — The staggering scope of Haiti's nightmare came into sharper focus Monday as authorities estimated 200,000 dead and 1.5 million homeless in the quake-ravaged heart of this tragic land, where injured survivors still died in the streets, doctors pleaded for help and looters slashed at one another in the rubble.
The world pledged more money, food, medicine and police. Some 2,000 U.S. Marines steamed into nearby waters. And ex-president Bill Clinton, special U.N. envoy, flew in to offer support. Six days after the earthquake struck, search teams still pulled buried survivors from the ruins.
But hour by hour the unmet needs of hundreds of thousands grew.
Overwhelmed surgeons appealed for anesthetics, scalpels, saws for cutting off crushed limbs. Uncounted thousands of survivors sought to cram onto buses headed out of town. In downtown streets, others begged for basics.
"Have we been abandoned? Where is the food?" shouted one man, Jean Michel Jeantet.
The U.N. World Food Program (WFP) said it expected to boost operations from feeding 67,000 people on Sunday to 97,000 on Monday. But it needs 100 million prepared meals over the next 30 days, and it appealed for more government donations.
"I know that aid cannot come soon enough," U.N. Secretary-General Ban Ki-moon said in New York after returning from Haiti.
"Unplug the bottlenecks," he urged.
In one step to reassure frustrated aid groups, the U.S. military agreed to give aid deliveries priority over military flights at the now-U.S.-run airport here, the WFP announced in Rome. The Americans' handling of civilian flights had angered some humanitarian officials.
Looting and violence flared again Monday, as hundreds clambered over the broken walls of shops to grab anything they could – including toothpaste, now valuable for lining nostrils against the stench of Port-au-Prince's dead. Police fired into the air as young men fought each other over rum and beer with broken bottles and machetes.
Hard-pressed medical teams sometimes had to take time away from quake victims to deal with gunshot wounds, said Loris de Filippi of Doctors Without Borders. In the Montrissant neighborhood, Red Cross doctors working in shipping containers and saying they "cannot cope" lost 50 patients over two days, said international Red Cross spokesman Simon Schorno.
Amid the debris and the smoke of bodies being burned, dozens of international rescue teams dug on in search of buried survivors. And on Monday afternoon, some 140 hours after the quake, they pulled two Haitian women alive from a collapsed university building. At a destroyed downtown bank, another team believed it was just hours from saving a trapped employee.
The latest casualty report, from the European Commission citing Haitian government figures, doubled previous estimates of the dead from the magnitude-7.0 quake, to approximately 200,000, with some 70,000 bodies recovered and trucked off to mass graves.
If accurate, that would make Haiti's catastrophe about as deadly as the 2004 Indian Ocean tsunami, which killed an estimated 230,000 people in a dozen countries.
European Commission analysts estimate 250,000 were injured and 1.5 million were made homeless. Masses are living under plastic sheets in makeshift camps and in dust-covered automobiles, or had taken to the road seeking out relatives in the safer countryside.
On the capital's southern edge, thousands of people struggled to get onto brightly painted "tap-tap" buses heading out of town.
"We've got no more food and no more house, so leaving is the only thing to do," said Livena Livel, 22, fleeing with her 1-year-old daughter and six other relatives to her father's house in Les Cayes, near Haiti's western tip.
"At least over there we can farm for food," she said.
She said she was spending her last cash on the "insanely expensive" bus fare, jacked up to the equivalent of $7.70, three days' pay for most Haitians, because gasoline prices had doubled.
The European Union and its individual governments boosted their aid pledges for Haiti to euro422 million ($606 million) in emergency and long-term aid, on top of at least $100 million pledged by the U.S.
A dirt-poor nation long at the bottom of the heap, Haiti will need years or decades of expanded aid to rebuild. After meeting with Haitian President Rene Preval and other international representatives in the neighboring Dominican Republic, Dominican President Leonel Fernandez said Haiti would need $10 billion over five years.
For the moment, however, front-line relief workers want simply to get food and water to the hungry and thirsty.
The U.N. humanitarian chief, John Holmes, said in New York not all 15 planned U.N. food distribution points were up and running yet. "That's a question of people, trucks, fuel, but the aid is scaling up very rapidly," he said.
The priorities are clearing roads, ensuring security at U.N. distribution points, getting this city's seaport working again and bringing in more trucks and helicopters, WFP Executive Director Josette Sheeran said in Rome.
Evidence of the shortfall could be found at a makeshift camp of 50,000 displaced people spread over a hillside golf course overlooking the city. Leaders there said a U.S. 82nd Airborne Division unit had been able to deliver food to only half the people.
The 1,700 U.S. troops on the ground in Port-au-Prince were to be reinforced by 2,000 Marines, who Marine Corps Capt. Clark Carpenter, a spokesman, said were off shore Monday. Other U.S. help was on the way, including two U.S. civilian crane ships that could unload cargo at the quake-damaged port.
Getting clean water into people's hands was still a dire concern.
"People can survive a few days without food but we must try to avoid major outbreaks of waterborne disease," said Brian Feagans, a spokesman for the aid group CARE.
Clinton and accompanying daughter Chelsea pitched in, helping unload cases of bottled water from their plane to a U.N. truck.
Some aid groups and foreign officials have blamed the U.S. military for slowing down aid deliveries, saying the American units that took charge of the small Port-au-Prince airport last week gave priority to U.S. military flights.
Doctors Without Borders said Monday its specialists were 48 hours behind on performing surgery for critically injured patients because three cargo planes loaded with supplies were denied clearance and forced to land almost 200 miles away in Santo Domingo, Dominican Republic.
The WFP's Sheeran said things would change. She announced an agreement with the U.S. so that "we now have the coordination mechanism to prioritize the humanitarian flights coming in."
At the airport, a U.S. military spokesman said the parking ramp designed for 16 large aircraft at times was holding 40. "That's why there was gridlock," said Navy Cmdr. Chris Lounderman. He said about 100 flights a day were now landing.
The U.S. Air Force itself resorted to an air drop of aid Monday. A C-17 from Pope Air Force Base, N.C., parachuted pallets of food and water into an area outside Port-au-Prince secured by U.S. forces. The Americans have been reluctant to use air drops for fear of drawing unruly crowds.
There remained a "huge demand for lifesaving surgery for those who suffered terrible injuries," Doctors Without Borders reported. The U.S.-based Partners in Health, coordinating aid at Port-au-Prince's central hospital, reported "a desperate need for all the resources required to run a hospital," including surgical instruments, anesthesia gear, alcohol, sutures, and saws.
Clinton, visiting the hospital, reported its staff had to use vodka to sterilize equipment. "It's astonishing what the Haitians have been able to accomplish," he said.
More than 1,000 patients awaited surgery at the hospital, Partners in Health said. Right outside the U.S.-run airport, one man died as Navy helicopters scrambled to evacuate patients to the aircraft carrier USS Carl Vinson, the military reported.
Across the city, thousands of abandoned bodies had been picked up by government crews, but residents dragged still others to crossroads, hoping municipal garbage trucks or aid groups would deal with them.
Looting and violence added to the casualties. Riot police opened fire – mostly in the air – to break up a mob of several hundred fighting over rum bottles in a burning shop. One teenage boy was hit in the thigh by a shotgun blast. "Friends! Save me! Save me!" he cried, curled up in a pool of blood, one foot almost severed. A medical aid truck happened by and picked him up.
The ranks of Haitian police and U.N. peacekeepers trying to restore order in this stricken city had themselves been decimated in the quake, which destroyed the U.N. headquarters.
In New York on Monday, U.N. chief Ban asked for 1,500 more U.N. police and 2,000 more peacekeepers to join the 9,000 or so U.N. security personnel in Haiti. Alain Le Roy, the U.N. peacekeeping chief, said a "tremendous" number of requests had come in to escort humanitarian convoys. Haitian police had returned to the streets in only "limited numbers," he said.
The Security Council was expected to approve the reinforcements on Tuesday.
Associated Press writers contributing to this story included Tamara Lush, Jonathan M. Katz, Michelle Faul, Kevin Maurer in Port-au-Prince; Ramon Almanzar in Santo Domingo, Dominican Republic; Edith M. Lederer at the United Nations; Raf Casert in Brussels; Larry Margasak and Pauline Jelinek in Washington.