Cyclone-torn Vanuatu is in desperate need of food, clothing, medicine and basic shelter - and a full recovery operation could cost hundreds of millions of dollars, disaster relief organisations say.
The Pacific island nation's President, Baldwin Lonsdale, has spoken tearfully of "a paradise" lost, needing to rebuild from scratch after winds of up to 320km/h, storm surges and floods smashed the country.
The full scale of the devastation is yet to emerge, but aid agencies are already warning of a dire situation.
Unicef said countless children, already destitute, were now at risk of disease as multiple disasters conspired to bring more misery to Vanuatu.
NZ Tear Fund chief executive Ian McInnes, who heads the New Zealand Disaster Relief Forum, yesterday said Cyclone Pam had ruined crops, threatening food shortages and compounding the humanitarian disaster.
He said accurate reports from some of Vanuatu's remote islands were slow to arrive, and it would take days or weeks to fully assess the catastrophe.
"We're suspecting tremendous damage but as of yet we really don't know."
However, it was clear the Melanesian country of 260,000 needed help with clothing, food, basic shelter, medical supplies, water, and other necessities.
Mr McInnes said there was "no question" the relief effort would cost tens of millions, if not hundreds of millions of dollars.
He said Vanuatu's farms and food supplies were wrecked, and its ruined housing stock - mostly made of traditional wood and thatch or other vulnerable materials - might have to be rebuilt in much sturdier fashion.
Aid agencies including Save the Children said the death toll of eight was expected to rise and many people lacked goods essential to survival.
About 60,000 children in Vanuatu were thought to have been affected, Unicef executive director Vivien Maidaborn said.
Reports of total devastation were emerging from the southern island of Tanna, she said.
Unicef had spent years developing Tanna's water, sanitation and hygiene facilities but it seemed Pam obliterated nearly everything in sight. Even concrete buildings on Tanna were flattened.
"There's no word for it except we're feeling incredibly distressed," Ms Maidaborn said.
Aid workers have warned the next few hours and days would be crucial to stopping a greater catastrophe.
Ms Maidaborn said an urgent need existed for medical supplies to stop the looming threat of disease.
"One of the concerns we've got is that there have been measles outbreaks as recently as the beginning of March."
Now, hungry and thirsty babies were at risk of drinking unsanitary water, she said.
Threats around health, nutrition, and schooling were also looming, Unicef said.
The agency also warned of safety threats, as Vanuatu imposed a 6pm to 6am curfew to prevent looting.
Aid groups said although many people instinctively wanted to donate goods or hampers to Vanuatu, it was better to make financial donations to established charities and agencies with experience distributing aid as needed.
Save the Children warned of "door-knocker scams" already emerging in Australia, and advised donors to ask for identification and only donate through major organisations.
The Red Cross said it had more than 200 volunteers "on the ground" in Vanuatu. The organisation said it was giving first aid to injured people, supporting others at evacuation centres, and visiting homes to check on families.
It said it was also distributing food, water and relief items such as soap, kitchen supplies and tarpaulins to people.
Prime Minister John Key yesterday said New Zealanders who wanted to leave Vanuatu would be offered flights when an Air Force C-130 Hercules left the country.
He said priority would be given to those with medical conditions, the elderly and those with young children.
Mr Key said the High Commission in Vanuatu was contacting New Zealanders to check on them, and there had been no reports of casualties so far.
The Government has so far given $2.5 million toward the relief effort after Cyclone Pam hit Vanuatu and has sent supplies on the Hercules, which left on Sunday.
The Ministry of Foreign Affairs and Trade was also advising people not to visit Vanuatu unless it was essential.
Four Volunteer Service Abroad (VSA) volunteers remained unaccounted for yesterday.
In a statement on its website, VSA said 19 volunteers in Port Vila and Santo were confirmed safe, but four on the islands of Pentecost, Malekula and Tanna were yet to make contact.
Communications were still down on these islands, a VSA spokesman said.
"All volunteers were in secure accommodation with extra supplies before the cyclone hit and we were in constant communication."
The spokesman was unable to confirm whether the four people missing were New Zealanders, out of respect for the families involved.
Rescued Kiwi: 'Houses just obliterated'
The only Kiwi rescued from an island which has "lost everything" broke down in tears describing the mess from which he escaped.
Mike Keegan, 73, was one of only three people taken off remote Tanna yesterday after fears for his health.
"It was terrible. Just terrible. I've driven around Port Vila today and they think it is bad but you haven't seen damage like it [on Tanna]. "There's not a tree left. All around us the houses were obliterated."
Keegan said he and a dozen others sheltered in a corridor.
The storm outside sounded like a jet landing. "It never let up."
After three days without power, phone or water, a Cessna flew into Tanna yesterday with radio engineers on board to fix airport communications.
'"We have one space left,' they [the plane's crew] said. 'Where is the sick man?' And that was me."
Keegan said only two other people, two Frenchmen, had been taken off the island, which was believed to be the worst hit by Cyclone Pam.
Keegan, his voice shaking, described how when he got to Port Vila, consular staff put him on the phone to his daughter. "It was very very good to hear her voice." He said he had been very emotional since learning he would get a flight out.
His thoughts were with the people left behind. "You have to give it to them. They've lost everything and they just keep smiling."
Unicef: Vanuatu islanders face starvation 'within days'
The entire population of one of Vanuatu's biggest islands faces starvation within days, with 100 per cent of crops destroyed by Cyclone Pam, Unicef officials warned last night.
The island's crops have been totally destroyed and concern is growing for the fate of the islanders, who have just a few days of fruit and root vegetables left. Speaking to The Independent yesterday, Alice Clements, a spokesperson for Unicef Pacific, based in the capital, Port Vila, said: "We have discovered that 100 per cent of crops in Tanna have been destroyed - this means that this is an island with no food."
Senior government officials struggled to maintain their composure at a briefing in Port Vila yesterday. Up to 80 per cent of the population of Tanna has been displaced and an official described the "devastation" he saw there, with trees stripped bare and looking like "skeletons". Ms Clements, one of those attending the briefing, was struck by the "very emotional" state of the senior officials. "We have about a week to get food to these people because after that, they have no food," she said. There is also the problem of contaminated water supplies, and no power or shelter in many areas.
The death toll now stands at 11, with dozens injured, but is expected to rise and "there are serious concerns about food security," according to Ms Clements.
Baldwin Lonsdale, Vanuatu's President, appealed for help as the full extent of the disaster began to emerge yesterday. Ironically, Mr Lonsdale had been attending a disaster conference in Japan, when the cyclone - with winds of up to 200 miles an hour - struck last weekend. Speaking before he left to return to Vanuatu, he spoke of the "monster" cyclone which had "completely destroyed" parts of his country. In the capital, Port Vila, almost every building has been destroyed or damaged. "The humanitarian need is immediate," he said.
A C-17 transport plane with emergency supplies took off from RAF Brize Norton, Oxfordshire, yesterday - part of a growing international effort involving countries from around the world, as well as relief agencies and the World Health Organisation. Vanuatu has a population of around 268,000 spread over 65 islands. It is like dealing with "65 simultaneous emergencies potentially," and problems getting out to many of the islands mean "it's incredibly difficult to get the real answer on what the situation is here," said Ms Clements.
The force of the cyclone "was much stronger" than Hurricane Katrina, which left a trail of destruction when it hit the US in 2005.
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- Additional reporting: Nikki Papatsoumas, Claire Trevett, Kristy Johnston, Independent