'We are not giving up. We will dig for as long as it takes'

Halfway up a mountain of rubble, on the site of what was once a three-storey apartment block in the Canape Vert neighbourhood, you started to hear the screams. A woman was buried underneath the concrete, apparently with her entire family. She had been there five days, and now that a search-and-rescue crew had finally arrived, she was in hysterics.

"There are several people alive underneath. We think at least five," said Marqueli Louradel, who was leading a team of local men hacking through the concrete with sledgehammers and pick-axes. "Six children lived there. But it's impossible to tell if they all survived. When we stop digging or making a noise she screams. She's terrified we will give up and walk away."

Mr Louradel, a local volunteer wearing a bright orange baseball cap to identify himself as a rescuer, rather than a looter, estimated that it would take another three hours to get through the first concrete panel leading to the air pocket. If more debris was in the way, it could take longer. "We're not giving up, though," he said. "We'll stay here all night if we have to."

Across Port-au-Prince, identical scenes were being played out yesterday, as Haitians and foreign teams made a frantic final effort to save victims trapped in the rubble of Tuesday's earthquake. They don't have long left. Already, most of the survivors are terribly dehydrated, after almost a week underground, and many of the people they were originally trapped with are already dead. At the municipal hospice just a mile from the airport, 85 elderly people were starving to death yesterday. One man, 70-year-old Joseph Julien, had already died for the lack of food, and his body still lies alongside the living on a mattress outside the collapsed building. Without help, administrator Jean Emmanuel told the Associated Press, "others won't live until tonight".

Mr Julien is part of what is now a momentous tally. Government officials now say that 100,000 is a minimum death count, and the toll could be twice that. One Briton, a UN worker Frederick Wooldridge, was confirmed among their number yesterday. Some 2 million people across the country need emergency relief. Foreign aid is starting to arrive on the streets, but only in dribs and drabs. Oxfam managed to install two water distribution centres yesterday, and small numbers of portable toilets have been dropped in some of the large squares where tens of thousand of the homeless sleep under tarpaulins.

I saw three rubbish trucks trundling through the streets picking up bodies, and several large fires in riverbeds, where the authorities are attempting to dispose of some of the mountains of rubbish. But meaningful quantities of food and medicine are still failing to reach the places they are most needed.

The situation is hardly less bleak in the country beyond the capital. And isolated survivors in the rest of Haiti are crying out for help that has so far been unable to reach them.

In Leogane, a port town 18 miles from the capital and close to the epicentre of the quake, around 90 per cent of buildings have been levelled, and residents say they have not received any help yet. The situation is similar in nearby Petit Goâve. "We don't have any aid, nothing at all," one survivor said. "No food, no water, no medical, no doctors." Five thousand displaced people have set up camps in one small village near by, according to the BBC. A Save The Children health worker on a preliminary visit said that residents reported hearing the moans of people under rubble they were unable to lift because of a lack of equipment. The cries have since stopped.

In Jacmel, a town of 40,000 on the southern coast, residents say they have been forgotten. "What about us?" asked Melanie Piard, who was back in the town from her home in Montreal after a bereavement. "We're stuck here." A Unicef co-ordinator there said moving people to the capital was out of the question. "It's almost impossible to send people to Port-Au-Prince," Tameka Donatien told The Miami Herald. "It's a complete mess and we don't want to complicate things."

Aid agencies are now stepping up their efforts to get aid to more remote areas. "They haven't had any aid delivered yet," said Jon Bugge, a Save The Children worker in Port-Au-Prince. "The damage is as bad in some places as the capital but they haven't had search-and-rescue teams, hospitals are in ruins, they're living in makeshift camps without food or water or any kind of cover. The basics still haven't been met. We need to get that in place."

And yet for now, even the capital is woefully short of essentials. "I haven't eaten since Thursday," said Chrisla Aberlam, a 33-year-old woman standing next to the ruined apartment block in Canape Vert. "I lost everything when it fell, except the clothes on my back. My brother lived in there with me, and he is now in hospital. His head was smashed in a very bad way. I don't have money to buy food, so have come back to see if there's anything I can find in the ruins."

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Food is only available to those who have money to pay for it. And vendors have dramatically raised prices. Most are quoting around $4 (£2.50) for a small bag of rice: an impossible sum in a country where half the population has to live on less than a dollar a day.

Occasional groups of UN troops and Haitian police are starting to tour the streets; yesterday 40,000 people were fed, a number that it is hoped can be increased to 1 million within a fortnight. Forty soldiers guarded UN food trucks near the ruined presidential palace. But I've yet to encounter a single US soldier in the capital, despite President Obama's claim that thousands are already in Haiti, with many more due to arrive today.

In the absence of a meaningful security presence, small outbreaks of looting and violence are being reported, particularly on the Boulevard Jean-Jacques Dessalines, Haiti's main shopping street, where store owners and policemen fired on crowds attempting to steal basic food supplies and cooking utensils yesterday. Every third building on the street is already destroyed and many have doors wrenched off their hinges. Two looters were reported dead in the centre of town, while two others were caught by crowds in Del Mar. They were tied together, flogged, and dragged through the streets by rope attached to the back of a truck, before being left in the gutter, unconscious.

The public's biggest fear, though, is armed robbery. In Petionville, a hillside suburb on the south-eastern side of Port-au-Prince, I saw the grizzly aftermath of the lynching of one criminal: a charred body, still smoking, lay by the side of the road between a church and an art gallery. The remains of a tyre were round the corpse's neck. It had been filled with petrol, and set on fire.

His crime? Killing the man who ran the local juice stall, with a revolver. Alerted by the sound of a gunshot, an angry crowd of about 25 men set upon him. Five policemen had stood less than a 100 yards away and watched the mob justice being delivered.

"He was a murderer, and the people need to fight fire with fire," said Antoine Miguel, who witnessed the attack. "If we don't look after ourselves, no one will do it for us. And we are all scared, very scared. Our prison has fallen to the ground, and some very bad people are around. In the square in Petionville last night, a man's throat was cut by a thief."

"Burning a man alive is not good justice. And of course this is not the rule of law, or a correct system. But please tell me: what is the alternative?" A US general, Ken Keen, warned that the violence was hindering rescue work. "We are going to have to address the situation of security," he said. "We've had incidents of violence that impede our ability to support the government of Haiti and answer the challenges this country faces."

But with the Haitian government still virtually paralysed – President René Preval is now living at the judicial police headquarters, where he conducts cabinet sessions and meetings with foreign ambassadors outdoors on plastic chairs – the prospect of a return to law and order looks remote. "Everything in Haiti is broken," said Information Minister Marie Laurence Jocelyn Lassegue. "All the ministries are fallen. There is not one person in the country without a friend or family member dead. When they say the government is not fast, we are truly doing our best."

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That is one reason for the delays to the arrival of aid that has been promised for days. Huge shipments are still held up at the city's tiny airport, which can take just 90 incoming flights a day, leaving cargo planes loaded with supplies stranded in foreign countries. And aid organisations say the US military running air-traffic control at the congested runway is prioritising the shipment of US troops over that of vital medical supplies and food.

Médecins Sans Frontieres has tried to get 130 tonnes of medical equipment and supplies into the country – but so far only 50 tonnes have made it. The most needed thing at the moment is medical and surgical care," said Filipe Ribeiro, MSF's executive director in Paris. "We must have planes carrying medical and surgical equipment given priority. I would like to know who's in charge, the Haitian government or the US? We don't know who is establishing the list of priorities. We are in contact with people in the US and locally and the UN, and we have to make a hundred phone calls instead of only one."

Officials with the charity complained yesterday that a plane carrying an inflatable surgical hospital had been rerouted to the Dominican Republic after circling over the Haitian capital for several hours, meaning that it had to be sent by truck instead. Its arrival on the ground was delayed by 24 hours. "This hospital was very much awaited by our teams," Mr Ribeiro said.

The UN is planning to use the Sylvio Cator Stadium, where Haiti's national football team plays, as a central staging post to distribute food and water in the city centre. Supplies will be shipped from there to 22 sites around town run by foreign aid agencies, and protected by UN and US troops, where it will be distributed. The system is due to be working by tonight, and helicopters were airlifting crates on to the sports field all day yesterday.

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Christians in Port-Au-Prince sought spiritual solace at the city's shattered cathedral, singing hymns and asking God for answers as military helicopters flew over the roofless nave. And across the city yesterday the faithful listened to God's representatives, their belief surely shaken by the horrors unfolding around them.

At the Episcopal Church in Carrefour, one of the worst-affected neighbourhoods, the vicar Paul Frantz Cole was attempting to reaffirm his congregation's belief. Roughly a hundred worshippers sang hymns, held hands, and listened to the nearest thing the 52-year-old preacher could offer to an uplifting sermon. His pulpit had been moved outside, amid fears that the damaged church building is about to collapse.

"As Christians, we depend on God, and we need to keep our eyes towards him," he said. "It isn't just chance that we are still here and have managed to survive the earthquake. It is God's will. We must put ourselves at his mercy and ask for his protection."

Mr Frantz Cole could certainly use some divine intervention. A hundred people have been sleeping on mattresses in the churchyard, with their nearby houses demolished, for five nights now. They have no drinking water, so are getting barely-treated supplies from a broken nearby water main, and sharing what small amounts of food they can muster.

"We have nothing. People came here with nothing but what they were standing in, and we are going to do what we can to help each other. Between us, we have about $10 left, and I am heading into town later to see what that can buy." Outside the gates to his church, Mr Franz Cole had hung a banner. "HELP US WE NEED FOODS!" it said. Worried that many Haitians are following the lead of Mr Franz Cole's flock, and drinking untreated water, the Mayor's office sent a fleet of vehicles round Port-au-Prince with loudspeakers delivering advice on how prevent outbreaks of cholera and dysentry. But the absence of drinking water leaves them few other options.

"I have no money, and there are six people in my family, and we can't survive without water, so yes, we have all been drinking the dirty water," said Ilo Fene, whose home is now a mattress at the Episcopal Church. "The alternative is to die of thirst. Everyone keeps saying that help will arrive from outside tomorrow, and the hope keeps us going. But so far, nothing has come.

"Tell your country: if they don't deliver food, people will riot. Hundreds of thousands could die. These are people who usually are peaceful, but the hunger stirs their conservation instinct. We have a saying in Haiti: tough times awaken the devil inside you. That is what you are seeing in Haiti today."