Anite Figaro remembers the night her isolated mountain community fled their homes in October as Hurricane Matthew scythed across south-west Haiti.

Battling their way through darkness, mud and flying debris that included corrugated iron roofs ripped from their flimsy shacks, families struggled to seek refuge in neighbours’ homes – before realising that no building was safe.

“The winds were so heavy that we fell over and just lay down on the ground waiting for them to die down,” Figaro said, recalling that the few dozen inhabitants of Cabi finally managed to cram themselves into a cave for the night.

The story was taken up by Chericiane Gay, another of the older women in the village, reachable by a steep four-hour drive from the hurricane-stricken city of Jérémie, along roads often partially destroyed by landslides and submerged in flood water.

“It feels like the only thing we are left with is our breath, and we thank God for that,” she said, adding that an earthquake days later shook an area where, in some villages, every home had already been demolished and where survivors have yet to be reached by relief efforts from the Haitian government or major international bodies such as the World Food Programme. In the case of Cabi, a lifeline came in the form of tarpaulins and food supplies provided by the NGO ActionAid, via local Haitian partners.

Little wonder then, perhaps, that the villagers and many others in the western hemisphere’s poorest nation feel forgotten, not just by their own government but by the rest of the world. A year of political uncertainty may now be at an end, however, after Haitans chose banana exporter Jovenel Moïse as their next president following a first round of presidential, parliamentary and local elections. Provisional results indicated he won 56% of the vote, avoiding a runoff.

Haitians in Roche-à-Bateaux, Les Cayes, wait to receive food from the UN’s World Food Programme. Photograph: Hector Retamal/AFP/Getty Images

The operations director of the UN Office of Humanitarian Affairs, John Ging, in November chastised international donors for providing just 40% (now 46%) of the funding sought for a $120m (£94m) humanitarian appeal targeting the 750,000 Haitians still in need of support. “Forty per cent [of the funding] means that 60% of the [humanitarian work] is not being done. This means a lot of unnecessary suffering for people who have had their livelihoods and their homes completely wiped out,” said Ging.

According to the UN, 1.4 million Haitians have been directly affected, including some 175,000 internally displaced people who have been living in about 307 temporary shelters, including nearly a hundred schools.

At least 1,000 people are believed to have died. Particularly hard hit were those living in cities such as Jérémie, where 145mph winds levelled not just 80% of buildings but uprooted trees and stripped vegetation from what was once a lush green skyline.

For now, however, the major concern is of a looming food crisis if crops destroyed by the hurricane – in a region once regarded as Haiti’s bread basket – are not replanted.

In the city of Les Cayes, where three people were shot dead when restless crowds gathered around food distribution points, the outspoken mayor, Jean Gabriel Fortuné, said that a famine could not be ruled out.

Jean Gabriel Fortuné, mayor of Les Cayes, described the coordination of aid as ‘non-existent’. Photograph: Ben Quinn/The Guardian

“Neither the government nor the international community were prepared for a disaster of this level, but it helped open up our eyes about a reality that the Haitian state and the international community ignored. Most of the people affected were already living in dire misery, inhumane conditions,” Fortuné told the Guardian, describing the coordination of aid as “non-existent”.

Amid the sound of UN helicopters periodically passing overhead, Fortuné also gave voice to the frustration of many Haitians with the presence of the 4,900-strong peacekeeping force that was first deployed in 2004 to restore order following the overthrow of the then-president, Jean-Bertrand Aristide. Its stock had already plummeted as a result of Nepalese peacekeepers introducing cholera to Haiti, causing an outbreak that has claimed more than 9,000 lives.

“It’s almost as if they are using us as guinea pigs in a laboratory. There is no real problem with security. The population is pacified, even if they are living in poverty,” Fortuné added, insisting that diverting even half of the mission’s $346m a year budget would set Haiti on the path to sustained development.

Such sentiment towards the UN Minustah mission, and the broader multinational approach to Haiti, is not uncommon. It has ranged from impatience – at a weekly meeting of international actors in Jérémie, a Haitian worker stood up to voice his discontent at proceedings being conducted in English rather than French or Creole – to outright hostility and violence in the form of looting of humanitarian aid convoys in Les Cayes.

Sebastian Rhodes Stampa, disaster coordinator for the UN’s humanitarian affairs office, insisted most Haitians regarded humanitarian agencies as being in the country to help. “Security is a challenge but we are not targeted as individuals. In a situation like this, where we are initially prioritising the part of the population that is most at need, there are those who can feel left out,” he explained.

In terms of reaction to the immediate food crisis, he cited programmes such as a cash-for-work programme overseen by the UN development programme (UNDP) to clear arable land of hurricane debris, as well as distribution of seeds to farmers.

For the longer term too, smaller NGOs are among those preparing Haitians for a recurrence of a hurricane of similar force or a repeat of the 7.3 magnitude earthquake that in 2010 devastated the country’s capital, Port-au-Prince, and its surrounds.

To the west of Les Cayes, schemes being funded by the UK charity Christian Aid and local partner Koral include the establishing of early warning sirens on Haiti’s south coast. The upkeep of the solar-powered sirens will be paid for through their use as charging stations for mobile phone users.

Prospery Raymond, Christian Aid’s manager in Haiti, said: “Projects like this are one part of our response to what is a very complex situation that results from a combination of a recent drought, the hurricane and the subsequent flooding. We’re focusing on trying to build up shelter as much as possible, while trying to empower communities and making them feel that they have ownership of the recovery. Haitians are extremely thankful for the support from the international community but levels of that support are still quite low, with potentially very grave consequences.”

Those dreading the thought of hearing the sound of the sirens include Clomène Lubin, who ekes out a living selling water and snacks to local fishermen. Her 14-year-old daughter and wheelchair-bound 80-year-old mother live with her in a tiny home, recently fitted with a new roof thanks to support from Christian Aid.

The family initially refused to evacuate their home in the village of Aquin, believing that the calmness of the waters indicated little danger. “We thought nothing would happen, but at 2am the water and the winds started coming and members of the community returned with a boat to take us to safety,” she said. “We are back now, but we’re not secure. It’s where we’re obliged to live to work, but we now live in fear of the sea.”