This island home of ours has long known the power of wind and water. Yet nothing quite prepared us for the ferocity of Hurricane Melissa, which struck Jamaica with unprecedented force, ripping through parishes, homes, and lives.

According to official and satellite estimates, parts of Jamaica suffered the full brunt of a Category 5 storm as Melissa made landfall near New Hope, Westmoreland, with sustained winds of up to 185 mph (295 km/h). In parishes like St Elizabeth, Westmoreland, St James, Trelawny, Clarendon, Manchester, St Mary, and St Ann, entire communities are underwater, power and communications have been knocked out, and many roads have been torn apart. These areas will take months, if not longer, to fully recover.

Recent analyses show at least 19 confirmed deaths in Jamaica so far, and the number is expected to rise as emergency teams attempt to access remote and isolated communities. The economic damage is already estimated at billions of US dollars, striking a severe blow to infrastructure, homes, agriculture, and the livelihoods of countless families.

The Human Toll

When the roofs came off and the flood water rose, something deeper than mere brick and mortar was shaken. People’s sense of safety, dignity, and hope have been shattered. Imagine waking in the faint light to find the home you have known all your life unrecognisable, walls breached, ceiling gone, furniture floating, and children crying in the dark. That is the lived reality for many Jamaicans now.

From Bethel Town in Westmoreland a retired farmer lamented, “It’s wholesale. It’s not just one or two houses without roofs, its entire communities.” In St Elizabeth local reports described the unbearable stench of stagnant water, dead animals, and even decomposing human victims, with some bodies still lying where they fell. The emotional burden of living in such conditions is almost unimaginable.

Women face unique hardships. Menstrual hygiene, safe sanitation, and privacy are now luxuries in communities where toilets have been destroyed or rendered inaccessible. Families are receiving supplies like toilet paper and soap, but these have little use where there are no functioning lavatories. Mothers struggle to care for infants in contaminated environments, while children suffer sleepless nights and lingering fear.

The mental health impact is also immense. Jamaica already has many citizens silently coping with suicide, depression, anxiety, trauma, and many other mental health issues. The devastation caused by Melissa has only deepened those struggles. The uncertainty of when, or if, life will return to normal has left people feeling hopeless and overwhelmed. Psychological wounds, though less visible than the physical destruction, will require just as much attention and care.

Compounding all this is a growing public health concern. With stagnant water, decaying animal carcasses, and human remains in several areas, the conditions are ripe for outbreaks of leptospirosis, cholera, dengue, and other waterborne and vector-borne diseases. In communities without functioning toilets or clean water sources, the risk of infection and contamination is high. These health threats, combined with the emotional and physical toll of displacement, have created a humanitarian crisis that requires urgent, coordinated intervention.

Why the Current Relief Effort Needs Rethinking

Jamaica’s relief operations have been nothing short of heroic. Volunteers, government agencies, private citizens, and international partners have all mobilised to bring help to those most affected. Yet despite these commendable efforts, the current approach faces several critical challenges that must be urgently addressed if we are to truly meet the needs of our people.

Care packages have been distributed across the hardest-hit parishes with great effort and goodwill. However, these supplies often arrive where there are no functioning facilities to support their proper use. Toilets have been destroyed, water systems remain offline, and makeshift shelters are overcrowded or uninhabitable. People receive hygiene items, but without clean water or sanitation these items lose much of their value.

Evacuation procedures also proved inadequate. While orders were issued, many residents stayed behind — not from defiance, but from necessity. In some areas there were no safe shelters available, or the existing ones were deemed unsafe or overcrowded. Families with children, elderly relatives, or disabled members chose to remain in fragile homes because there was simply nowhere else to go. Their decision was not about resistance, it was about survival within a system that lacked the infrastructure to protect them.

Even after the storm, tragedy persists. Some bodies remain unrecovered, trapped under debris or inaccessible due to impassable roads. This delays closure for grieving families and increases health risks for communities already struggling to survive. The stench of death and decay is a constant reminder of both human loss and the urgency for structured, compassionate action.

Women and vulnerable groups continue to bear a disproportionate share of the suffering. The lack of privacy, proper sanitation, and reproductive health resources has placed an additional burden on them. These are the unseen crises that erode dignity and deepen trauma long after the winds have passed.

The overall relief strategy also remains fragmented. While there has been commendable effort in delivering supplies, there is a clear need for a coordinated evacuation and rehabilitation plan. True recovery must focus not only on immediate relief but on restoring health, dignity, and stability.

A Clear Path Forward

1) Centralised evacuation and care: The Government should immediately establish a large-scale, full-service evacuation hub, such as the National Arena in Kingston, to accommodate victims from the hardest-hit areas, including St Elizabeth, Westmoreland, Trelawny, Clarendon, Manchester, St James, St Mary, and St Ann. This hub would provide shelter, food, medical care, and psychological support in one safe, controlled location.

2) Medical and mental health screening: Deploy teams of doctors, nurses, mental health professionals, and social workers at the hub. Each evacuee should receive both physical and psychological assessments. Temporary clinics should be established to treat injuries, infections, dehydration, and trauma-related symptoms.

3) Sanitation, hygiene, and dignity: Provide functional toilets, showers, and waste disposal systems. Designate private, secure areas for women and girls. Relief packages must include context-appropriate items such as sanitary wear, clean clothing, and mobile sanitation units for communities where infrastructure has collapsed.

4) Disease prevention and health monitoring: Public health authorities must conduct immediate environmental clean-ups, chlorinate water sources, and deploy mobile health units. Urgent campaigns to prevent outbreaks of waterborne and vector-borne diseases such as leptospirosis, cholera, dengue, and malaria are critical.

5) Restoration of communication and access: Clearing blocked roads, restoring telecommunications, and reconnecting isolated communities must be prioritised. Accurate data collection on the missing, deceased, and displaced will enable a more effective and transparent response.

6) Long-term rehabilitation: Beyond immediate survival, Jamaica must invest in rebuilding homes, restoring livelihoods, and addressing the long-term mental health and social needs of survivors. Counselling, child-friendly spaces, and job training programmes can help communities regain purpose and stability.

7) Transparency and accountability: Establish a central command centre to provide daily updates on evacuees, shelter operations, disease control efforts, and resource allocation. Public trust depends on open communication and efficient management of relief resources.

Jamaicans are a people of strength and heart. From the shores of Negril to the hills of St Ann, we have endured much and always found a way to rise again. But this storm is unlike any before it. The devastation is deep and personal. Homes, communities, and spirits have been broken.

To save lives now and preserve dignity we must act with unity and urgency. Let us move beyond symbolic gestures. Let us care for our people in a comprehensive, coordinated, and compassionate way. Let our response to Hurricane Melissa be remembered not just for relief, but for renewal. When future generations ask what we did when Jamaica was brought to its knees, let the answer be this: We rose together.

Shawn Smith is a humanitarian, psychotherapist, advocate, and clinical social worker. Send comments to the Jamaica Observer and shawnthesocialpractitioner@gmail.com.

Women will face unique hardships with issues surrounding hygiene and privacy.