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Uwen Garae surveys the damage to his home in Port Vila, Vanuatu, after a cyclone ravaged the Pacific island over the weekend, March 16, 2015.DAVE HUNT/The New York Times

Relief workers rushed to deliver desperately needed food and water Wednesday to survivors living on Vanuatu's outer islands after a monstrous cyclone wiped out entire villages and flattened vast swathes of the South Pacific nation's landscape.

Planes carried food, water and medical supplies to hard-hit Tanna Island, where aerial assessments showed more than 80 per cent of homes or buildings had been partially or completely destroyed by Cyclone Pam. A boat stocked with canned goods, biscuits and water was expected to head to the island on Thursday.

"There's a landscape of skeleton trees and patchworks of square outlines where houses used to be," said Angus Hohenboken from aid group Oxfam. "It's really quite a saddening sight."

Lack of food was a growing worry for those who survived the storm, which packed winds of 270 kilometres (168 miles) per hour when it struck Saturday.

"Everyone in Tanna and other islands in the south, they really live subsistence lives, so they grow what they need for a short period. ... And the reality is that much of that would have been washed away by this storm," said Tom Perry, spokesman for CARE Australia. "That's a grave concern because we desperately need to get food to people soon."

The U.N. Office for the Coordination of Humanitarian Affairs reported that 11 people were confirmed dead, including five on Tanna. Officials with Vanuatu's National Disaster Management Office said they had no accurate figures on how many were dead, and aid agencies reported varying numbers.

Many people took shelter in larger buildings such as schools and churches, which likely spared their lives.

Vanuatu has a population of 267,000 people, with about 47,000 living in the capital, Port Vila. The string of islands is frequently subjected to natural disasters such as earthquakes and storms. Because of that, relief groups have outreach programs that teach residents how to prepare for disasters, and most communities have local buildings designated as evacuation centres during storms, said Hanna Butler, an aid worker with the Red Cross in Vanuatu.

Relief workers carrying medical and sanitation supplies, water, food and shelter equipment finally managed to reach Tanna and neighbouring Erromango Island after being stymied in their efforts for days by poor weather and a breakdown in communications. The two islands were directly in the path of the storm.

An aerial assessment showed extensive damage on Erromango, with communities ranging from 70 per cent to 100 per cent destroyed on the archipelago's fourth-largest island. On other islands, plane crews saw people had made big, white "H" marks on the ground, and people on Tongoa island flashed mirrors to attract attention, said Colin Collett van Rooyen, Vanuatu director for Oxfam.

On Tanna, the cyclone's fierce winds uprooted water tanks and blew them kilometres (miles) away, said Hohenboken from Oxfam, who travelled to the island. Crops were demolished and electricity was out, as the solar panels that power many homes were destroyed.

The island's hospital was operating with a diesel generator, but there was only enough fuel to last for two weeks, and some of the hospital's water supply was unusable due to contamination, he said.

On Wednesday, some residents were already beginning the process of rebuilding their houses and some had started re-planting crops, Hohenboken said.

"I think Vanuatuans are very resilient and kind of motivated people, but it's been a shock to this community," he said. "It was a storm on a scale that people really had no frame of reference for."

The storm, though massive, did not affect all islands equally. Butler, of the Red Cross, travelled to the southern islands of Futuna and Aneityum on Wednesday, and found both relatively unscathed. The village chief of Futuna told Butler that the only real damage was to the island's banana plantations and gardens; the sturdily-built houses weathered the storm just fine, and there were no deaths.

"Fly over Tanna, there's just not a green leaf left on a tree, and not so far away, these two little islands have really survived and the storm has obviously bypassed them," she said.

Meanwhile, fears of a measles outbreak prompted aid workers to launch an emergency vaccination drive for children across Vanuatu, which has low rates of immunization and already suffered one outbreak of the disease earlier this month. Teams were travelling to evacuation centres and other storm-ravaged areas around Port Vila to vaccinate children, provide Vitamin A and hand out bed nets to help stave off mosquito-borne malaria, according to UNICEF.

Baldwin Lonsdale, Vanuatu's president, returned to his country on Tuesday night from Japan, where had been attending a U.N. disaster conference when the cyclone struck.

"I trust the people of Vanuatu. I trust my government. I trust the people that they will stand united together as a nation and to rebuild the nation," he said.

Poor weather and communications issues have hampered relief workers' efforts to reach the outer islands for days. Most of the islands have no airports and those that do have only small landing strips that are tricky for large supply planes to navigate. On the main island of Efate, bridges were down outside Port Vila, impeding vehicle traffic.

The U.N. Office for the Coordination of Humanitarian Affairs said 3,300 people were sheltering in dozens of evacuation centres on Efate and in the provinces of Torba and Penama.

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