Approaching from the air, the first impression is that much of Gonaives is still under water.
By Jeremy Cooke
BBC correspondent, Gonaives, Haiti
As the helicopter descends to land, circling the city centre, there is the incredible sight of thousands of people crowded onto the flat roofs of their homes.
Any piece of land protruding from the flood has become a refuge
On the ground the main street is like a river, flowing with filthy, brown water.
Sometimes it is just a few inches deep, sometimes it is up to the waists of the survivors, who are trying to salvage what they can, wading through the mud carrying sticks of furniture, trying to find food.
The cathedral on the town square has become a refugee centre.
The ground floor is covered with liquefied mud.
Some families grieving for their dead sit on ramshackle pews to pray and shelter from the sun.
Upstairs, at balcony level, dozens of people have laid out mattresses and sit silently bewildered at what has happened to them.
Here we met Vivian Jacques cradling her one-year-old daughter, Lovely, whose face is badly scarred from the injuries she suffered while escaping the flood waters.
Vivian told us that she and her six children made it out of their home alive.
Her husband, 34-year-old Hubir, died along with hundreds of others.
On the streets every truck that moves, whether full or empty, is mobbed by survivors desperate for aid that is only just beginning to arrive.
At twilight the people of Gonaives climb back onto their rooftops, to an uneasy sleep, hoping that with daylight the water levels will once again have dropped.