People in isolated communities on the Caribbean coast of Nicaragua are running out of food nearly a week after Hurricane Felix hit the region. The Miskito people, most of whom live from subsistence farming, lost crucial rice, corn, bean and yucca crops in the flood waters.

"We have nothing to eat except what yucca we can salvage from the flooded fields," said Elna Osean, who has been camping in the open since the Wawa River overflowed, forcing her family and dozens of others from their riverbank homes. "Once that runs out, we don't know what we'll eat."

Osean said many children and adults were suffering from diarrhea and stomach pains from drinking water from a contaminated well, the only source available. "Our matches are even wet and useless," she added, as she blew on kindling to try to start a fire to cook over.

CARE is working to mobilize immediate food, water and crucial supplies for Osean's community and others like it. Survivors will also need long-term assistance to resume their lives, restore livelihoods and infrastructure, said Marcos Neto, CARE's program director for Central America, who is overseeing CARE's relief effort.

"The loss of life was less than we had feared, but property damage has left extremely poor people vulnerable, without access to food or clean water. These communities will need longer-term support."

CARE places special emphasis on meeting the needs of women in emergencies, since they are the primary caretakers of their families, he added.

Beyond the immediate wind damage to structures, overflowing rivers, including the Wawa in Nicaragua and the Ulúa in northwestern Honduras, have displaced tens of thousands of families.

Near Elna Osean's campfire, men were working to build a shelter frame out of tree branches but had no material to cover it. "We need plastic sheeting, and cords to tie it down," they said.

CARE estimates some 84,000 square meters of reinforced plastic will be needed over the next nine months, along with emergency food supplies and clean water for communities whose crops were destroyed and wells contaminated. Metal sheeting and nails to repair roofs and restore permanent dwellings are also desperately needed.

"Reaching the most isolated survivors with aid remains a challenge," said Netos. "Even under the best of circumstances, many Miskito communities are very isolated." Some communities are reachable only by helicopter or boat, and the few air and water craft available in the region have been much in demand.

In Nicaragua, CARE is distributing packets of food and emergency supplies through local partners and has flown specialists in water, sanitation, and psychosocial support into the region.

In Honduras, where more than 25,000 people have had to be evacuated from their homes and have health and food needs, CARE is providing short-term assistance and evaluating damage to be overcome during the rehabilitation phase.

"We are committed not just to immediate relief, but to helping people restore their homes, health, and livelihoods," said Neto.