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After hammering the Bahamas and leaving at least 30 dead, Hurricane Dorian began raking the south-east US seaboard, with the eye hitting the North Carolina coast on Thursday evening.

The threat to the US remains real but in the Bahamas the storm has left such terrible devastation that the authorities were still struggling to get aid to stricken areas and the death toll is expected to rise, perhaps steeply.

In Abaco alone, the government has taken delivery of at least 200 body bags, according to local media on Thursday.

Dorian made landfall over Abaco and Grand Bahama on Sunday, then stayed where it was, the nation’s strongest hurricane on record. Category 5 winds of up to 185mph obliterated entire neighborhoods and triggered a humanitarian crisis.

On Thursday Luíz David Rodriguez, the programme manager for the NGO Direct Relief, spoke to the Guardian from Abaco, via satellite phone. He had witnessed disturbing scenes outside the island’s main health clinic, near Marsh Harbour.

The clinic has the capacity to deal with about 20 people but Rodriguez estimated there were between 1,500 and 2,000 people waiting in the area around it.

“Lots of people are just laying around,” he said, “waiting to get off the island. People are getting a little desperate.”

It was too early to properly assess the most pressing health concerns, he said, suggesting many were simply exhausted. Aid groups have been struggling to deliver basic supplies due to the level of destruction. On Thursday, some planes were able to land.

“Everything is destroyed,” Rodriguez said, adding that much of the flooding had begun to subside.

Damaged caused by Hurricane Dorian in Marsh Harbour, Great Abaco Island, on 5 September.




Damaged caused by Hurricane Dorian in Marsh Harbour, Great Abaco Island, on Thursday. Photograph: Brendan Smialowski/AFP/Getty Images

At the Bahamas National Emergency Management Agency headquarters in the capital, Nassau, a delegation of Caribbean leaders set off for a flyover trip to see the destruction on the Abaco Islands.

Mia Mottley, the prime minister of Barbados, spoke about her thoughts on Dorian’s links to the climate crisis. She did not pull her punches.

“We are on the frontline of the consequences of climate change but we don’t cause it,” she said. “And the vulnerability that attaches therefore to us is a matter we’re trying to get the international community to deal with consistently.”

She added: “People say the words and hear you, but they don’t follow through so that I have every confidence. Now that the last few years are beginning to show others that frontline states, whether it’s an island in the Caribbean or states in the US or cities, all of us who are continuously being affected, have to recognise that this doesn’t happen out of the blue.

“The warmer waters do what? They fuel the growth and the strength of hurricanes.”

Sarah St George, the chairman of the Grand Bahama Port Authority, told the Guardian that the “force and size” of Dorian took everyone by surprise.

“Grand Bahama is not in good shape at all because 70% of it was under water,” St George said. “On the north side of the island the water was coming up to the second floor of their houses. My assistant Tammy was on the roof of her house for 30 hours hanging on to a coconut tree with her eight-year-old daughter, Ariana. Her grandmother lost her grip and slipped off the roof and drowned. There was no way of getting to them. They’ve lost everything.”

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In Abaco, some dazed survivors struggled back towards shantytown homes on Thursday, but found them razed.

The small community, known as the Mudd and built by Haitian migrants over decades was reduced to splinters. The people picked through debris, avoiding a body underneath a tree branch with its hands stretched toward the sky – one of at least nine bodies reported in the area.

“Ain’t nobody come to get them,” said Cardot Ked, a carpenter, originally from Haiti, who had lived in Abaco for 25 years.

Meanwhile, with winds still at 110mph on Thursday, Dorian was a threat to hundreds of miles of US coastline. The US National Hurricane Center (NHC) said it was expected to gradually weaken through Saturday.

The core of the storm hit North Carolina on Thursday evening local time, with sustained winds of at least 100mph.

The NHC warned of life-threatening storm surge, flash-flooding and dangerous winds reaching into Virginia “regardless of the exact track of Dorian’s center”.

The North Carolina governor, Roy Cooper, had urged residents on Thursday “to stay in a safe place and off the roads”, warning “we have a long night ahead of us” as conditions deteriorated.

Dorian swept past Florida at a relatively safe distance, grazed Georgia, then began hugging the South Carolina coastline with howling winds and sideways rain.

An estimated 3 million people in Florida, Georgia and the Carolinas were warned to evacuate. Navy ships were ordered to ride it out at sea and aircraft were moved inland. At least four deaths in the south-eastern US so far have been blamed on the storm.

In Charleston, South Carolina, a historic port city of handsome antebellum homes on a peninsula prone to flooding, the power flickered on and off as the storm shrieked in and flooding began.

Dorian spun off tornados in the Carolinas, damaging homes.

By late morning in coastal Wilmington, North Carolina, rain swept sideways, trees bent and traffic lights swayed.

Additional reporting by Edward Helmore and agencies.