Last year, Haiti was devastated by four hurricanes in as many weeks, killing 1,000 people and leaving 800,000 homeless. Hundreds died in the town of Gonaives after many houses were completely submerged in water.
The last time I was here was just days after the disaster; flying into Gonaives, all I could see was water. This time things were different. The town was covered in towering piles of mud which the morning sun burned off into choking dust.
This white fug bleached Gonaives of colour and added to the continuing misery of so many here.
"I haven't been able to go back to my home yet," one woman told me. "I can't even get inside yet because the mud around it hasn't been cleaned away. It's still full of mud inside too."
A lot of time has passed and people seem to have forgotten about this area. Yet so many families need help.
Piles of soil, some more than three metres high, surrounded homes in parts of the town like fortified walls. These keep people out of their houses, where once they trapped them in.
At the town's hospital, long lines of women with small children, many of them looking emaciated, bear witness to the hurricanes' baleful legacy.
With only 2% of the country's forests left, top soil containing vital nutrients were washed away by the floods and crops have suffered, leaving many children malnourished in this, the poorest country in the western hemisphere.
The stark nature of the problem was brought home to me by a nurse, Natasha D'Jmbahteist: "Some of the children who come here now are in such a bad way that there is little we can do for them," she said. "They don't respond to treatment, so we have to send them away. And it breaks our hearts to do this."
"Waiting for God to advise"
On the main road just outside of Gonaives there is a large lake which stretches to the mountains in the far distance. Just a few months ago this huge body of water was farmland.
The people who lived on this underwater land now crowd together in lines of flimsy wood and canvas huts in one of two camps here for those made homeless by the hurricanes. This area, surrounded by flood waters, is known locally as the "desolate savannah".
Drying in the sun the mud creates dust clouds that choke the region
Justine, a elderly grandmother, stares at the ground as she talks. "The floods washed my pregnant daughter away, my husband also died, and our house was destroyed. I am always thinking of what I have lost, the children who have died in my hands."
And, standing by himself, at the back of the crowd around me, is a teenage boy in torn, threadbare clothes. Fifteen-year-old James Poule is still coming to terms with what happened one night last year: "I woke to find water pouring over my bed in the darkness. My clothes had all been washed away, along with everything I had.
"A little later my mother drowned. I was at the top of the house, and she was in the floor below and she couldn't climb up, so the water just washed her away. At least I was able to help save the lives of my two little brothers.
"I have absolutely nothing. I have no clothes, I don't even have any shoes. And I cannot go to school. I just sit around here waiting for God to advise me."
"Relocation is not an option"
All around me on a parched barren hill towering over Gonaives, hundreds of local people are gouging out terraces in the rocky soil, doing their bit to stop the town flooding again.
In addition to this food-for-work scheme run by the UN's World Food Programme, the nearby river Cant has been dredged to help prevent it bursting its banks and an emergency shelter for 2,500 people is under construction.
But, despite these relief efforts, some in Gonaives say the local authorities are doing next to nothing to help them.
"Maybe there are certain sectors which are not happy with what's been done," says the town's mayor, Stephan Maurice. "But from my personal opinion, I'm not saying it's perfect. I'm saying there is a certain calm and activity has resumed."
Many of the town's children are ill and malnourished
When I was last here, much of the city was submerged in metres of water. There was talk of moving Gonaives - or at least parts of it - on the grounds that, built on a flood plain, it's only a matter of time before it is swamped again.
So, why is this not being done? The UN Secretary General's Special Representative in Haiti, Hedi Annabi, told me this was a valid question: "But I was told by senior Haitian officials that this is the city where the independence was proclaimed. It has such a high symbolic city for the Haitians, that relocating the city is not an option."
Meanwhile, with this year's hurricane season continuing, grandmother Justine stares in trepidation at the stormy skies above.
Given the constant threat posed by yet more deadly winds, how long, I ask her, does she expect to stay in this ramshackle camp, besieged by flood waters and terrible memories?
"Forever, forever, until the day that death comes to me. Maybe the waters will rise again soon. We never know when we are going to die."
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