(This story was originally published September 10, 2008.)

PORT-AU-PRINCE -- The aerial view for Haiti's newly installed prime minister was brutal Tuesday: a storm-ravaged landscape stretching out for miles, flooded rice fields, washed-out cities and survivors battling rivers of mud.

But as Michèle Pierre-Louis surveyed the damage from a U.S. military chopper, three days after a fourth storm buffeted Haiti, she knew that the areas out of view -- remote communities hidden by mountains and cut off by impassable roads -- were likely worse off.

"It's very shocking, " said Pierre-Louis, who officially took charge of Haiti's government Friday. "It's very hard to see that people are now living on their roofs, and that is the only way they can survive."

From Haiti to Turks and Caicos and the Bahamas, Caribbean leaders surveying the devastation by air and land echoed a similar call: We need help.

"People are desperate for food, for drinkable water, " Pierre-Louis said. "This is the most urgent need."

As Pierre-Louis joined U.S. Ambassador Janet Sanderson for an overview of the affected region, U.S. military aboard a Navy hospital ship anchored off the coast of Port-au-Prince, U.N. peacekeepers and aid groups battled logistical issues to get sorely needed tarps, food and water to storm victims.

The four-storm death toll in Haiti was officially upgraded to 341.

In Cabaret, where 57 died when Ike struck Sunday, some help finally arrived Tuesday. Water trucks dispersed through the town, and a church group provided warm meals of beans and rice and spaghetti out of a pickup truck. People ate with whatever they could find -- baseball caps, leaves from fallen banana trees.

Concerned about the possibility of more deaths, Pierre-Louis said the government was seeking to declare a state of emergency, and looking for temporary "war" bridges to reconnect critical routes and get to those still stranded.

The prime minister said the priority was "evacuating people from the dangerous zone, bringing food, bringing water, bringing medical supplies and making sure that it goes to the beneficiary and not diverted by criminal hands."

In the northwestern port city of Gonaives, aid flights were not able to land and U.S. Navy personnel were forced to take 186,862 pounds of food into the city by sea because the ship's gigantic MH-53 Sea Stallion helicopters are too big for the tiny airstrip. The choppers, capable of carrying 11,000 pounds of food, were sent to Les Cayes, the flood-prone southern city cut off from the capital by an overflowing river.

"This is going to pick up and progress every day, " Mission Commander Fernandez "Frank" Ponds told Pierre-Louis as he showed her the ship's relief operation. More than 500 personnel have been loading and unloading food and preparing tens of thousands of gallons of water aboard the ship. A few miles north of Haiti, Bahamas Prime Minister Hubert Ingraham and Turks and Caicos Premier Michael Misick were surveying damage caused by Ike.

On the tiny Bahamian island of Great Inagua, dozens of locals showed up to meet Ingraham, who visited schools and other buildings damaged in the storm.

"We came here to see what relief theyll bring, " said Dennis Seymour, 44, a construction worker.

The island's lone settlement, Matthew Town, took a pounding from Ike. None of the 1,000 residents died, but churches lost steeples, homes were stripped of shingles and walls and telephone poles were knocked to the ground.