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At a Glance San Juan Mayor Carmen Yulín Cruz says "people are starting to die" as the island awaits further help.

Power problems are coloring every aspect of Puerto Rico's hurricane recovery efforts.

Gov. Ricardo Rosselló says the island is “essentially devastated" in the wake of Hurricane Maria.

Officials in Puerto Rico says the destruction from Hurricane Irma has set the island back nearly 20 to 30 years.

At least 45 people have been killed in the Caribbean by Hurricane Maria.

San Juan Mayor Carmen Yulin Cruz says Puerto Rico's humanitarian crisis is beginning to take a deadly toll on the island.

"It's life or death," San Juan Mayor Carmen Yulin Cruz told CBS News Tuesday morning of the situation in the US territory. "People are starting to die already . We need to get our shit together because people are dying. People are really dying. I've put them in the ambulances when they're gasping for air.

All across the island, a feeling of helplessness and desperation is beginning to grip residents like Yesenia Gomez, a San Juan kitchen worker who told The Associated Press "We're in God's hands," as she spent hours searching for a cell phone signal to contact her mother in the Dominican Republic.

There is "sheer pain in people’s eyes ," Cruz told the Washington Post. "They are kind of glazed. Not because of what has happened, but because of the difficulty of what will come."

Gov. Ricardo Rosselló told the Washington Post that the island is "essentially devastated. Complete destruction of the power infrastructure, severe destruction of the housing infrastructure, food and water are needed."

(MORE: U.S. Response Criticized as Too Slow, Not Enough )

Power and communications are still down for much of the island, the Post reports, and local law enforcement agencies are strained and hampered in their ability to reach far-flung areas that may still need relief. As of Monday morning, officials still had not had communication with nine of the island's 78 municipalities, Rosselló said in a press conference.

Power problems are coloring every aspect of Puerto Rico's hurricane recovery efforts, from grocery stores with no way to store perishables or process transactions to homes where people running low on food are also running low on fuel to cook it.

Cell phone reception is spotty; it's hard to contact relatives. Lack of air-conditioning and a "heat from hell" means even sleeping through the night is near impossible.

"We don't have a generator or a fan. We have nothing. The children get desperate," Miguel Martinez, whose family has been sleeping on their roof rather than inside their stifling home, told the AP. "It's a heat from hell."

Temperatures have been in the high 80s and low 90s, but the high humidity in the tropics has pushed the heat index over 100 degrees for several days, says weather.com meteorologist Linda Lam.

"Temperatures may drop slightly in the coming week, but the heat will still be oppressive, especially without access to air conditioning," Lam said.

Hospitals are running dangerously low on medical supplies and some don’t even have running water, CNN reported.

"I can't deny that the Puerto Rico of now is different from that of a week ago," Puerto Rico Resident Commissioner Jenniffer Gonzalez told AP. "The devastation in Puerto Rico has set us back nearly 20 to 30 years."

The desperate conditions are driving people to "hysteria" said Jose Sanchez Gonzalez, mayor of the northern town of Manati, where a hospital filled to capacity with patients is on the brink of collapse, according to the AP.

"People tell us often, 'I don’t have my medication, I don’t have my insulin. I don’t have food, I don’t have drinking water,'" Cruz told the Post. "We had 1,260 refugees. Most of them have gone home, and what have they gone home to? Nothing. No electricity, no drinking water. Literally no roof over their head."

Cruz and other local leaders have expressed concern that lawlessness could become a major factor in the coming days. Cruz said she knows that looting is already happening across her city.

"There is horror in the streets," she told the Post. "People are actually becoming prisoners in their own homes."

The official death toll has risen to at least 16 in the U.S. territory, and 45 across the Caribbean. Rosselló told The Weather Channel they were attempting to reach the most remote areas of the island by helicopter, as travel has been crippled by debris and downed power lines on Puerto Rico's roads. Officials said Saturday they still could not communicate with more than half the territory's towns.

President Donald Trump announced Tuesday that he would visit the territory next week , CNN reports. Speaking in the Oval Office, Trump said it was the earliest date he could reach the devastated island. He said he may also stop in the US Virgin Islands.

​​​​​​Puerto Rico

As much of the U.S. commonwealth remains in the dark, the federal government is rushing aid to the island in hopes that they can prevent a full-blown humanitarian disaster.

The U.S. Department of Energy (DOE) says it is coordinating with the Federal Emergency Management Agency (FEMA), the Puerto Rico Electric Power Authority, and a team from the New York Power Authority, the AP reported.

An eight-member team from the department's Western Area Power Authority that was deployed to Puerto Rico ahead of the storm and assisted with initial damage assessments has been redeployed to St. Thomas in the U.S. Virgin Islands. Additional DOE responders are prepared to deploy to Puerto Rico and will do so as soon as transportation is available.

(MORE: How to Find a Shelter in Puerto Rico/How to Get in Touch With Family Members )

Officials have opened the island's main port in the capital city of San Juan to allow 11 ships to bring in 1.6 million gallons of water, food, 23,000 cots and dozens of generators, according to the AP. In the upcoming days, more ships are expected to arrive.

The federal aid effort is racing to stem the crisis brewing in towns left without fresh water, fuel, electricity or phone service. Officials with FEMA, which is in charge of the relief effort, told AP they would take satellite phones to all of Puerto Rico's towns and cities, more than half of which were cut off following Maria's devastating crossing of the U.S. territory.

"Hysteria is starting to spread. The hospital is about to collapse. It's at capacity," Gonzalez told the AP with tears in his eyes. "We need someone to help us immediately."

On Sunday, government officials said engineers inspected the Guajataca Dam to determine the extent of damage caused by Hurricane Maria.

A crack was reportedly discovered by an engineer inspecting the 90-year-old dam, which could be the first sign of its total failure, National Weather Service meteorologist Anthony Reynes told the AP.

"There's no clue as to how long or how this can evolve. That is why the authorities are moving so fast because they also have the challenges of all the debris. It is a really, really dire situation," Reynes said. "They are trying to mobilize all the resources they can but it's not easy. We really don't know how long it would take for this failure to become a full break of the dam."

On Friday evening, authorities said they ordered the evacuation of 70,000 people living downstream from the dam in the northwestern part of the territory amid fears that the wall would fail.

Javier Jimenez, the mayor of the town of San Sebastian, said he believed the number of people needing to be evacuated was far smaller than the 70,000 reported. The NWS San Juan said a population of nearly 8,000 individuals lived within the area under the flash flood warning downstream from the dam, and Secretary of Public Affairs Ramon Rosario said about 300 families were in harm's way.

The AP noted that the discrepancy could not immediately be explained.

Rosselló implored people in the flood zone to evacuate immediately.

Abner Gomez, executive director of Puerto Rico's emergency management agency, told the New York Post Friday that the dam's floodgates suffered mechanical damage during the storm, which made it impossible for authorities to open and let out normal water currents.

Gomez noted that "there is no way to fix it" right now considering the conditions and said if the dam tops over or fails structurally, "thousands of people could die."

The Puerto Rico Electric Power Authority, which operates the dam, says that the failure is already causing flash flooding downstream. The dam lies across the Guajataca River to form a reservoir that can hold roughly 11 billion gallons of water.

According to El Nuevo Dio, government officials reported that people in one small community near the dam refused to evacuate. Authorities intended to enforce a law that allows responders to evacuate children and the elderly in an emergency.

New York Gov. Andrew Cuomo traveled to Puerto Rico to assess damage from Hurricane Maria and bring supplies and assistance, including National Guard personnel, Black Hawk helicopters, state troopers and donated supplies of water, ready-to-eat meals, canned goods, flashlights, cots, blankets and pillows, and 10 electrical generators.

The storm smashed into the U.S. territory on Sept. 20 as a Category 4 hurricane, twisting metal, snapping trees and utility poles and effectively paralyzing the island.

"Months and months and months and months are going to pass before we can recover from this," Felix Delgado, mayor of the northern coastal city of Cataño, told the AP.

According to the AP, 1,360 of the island's 1,600 cellphone towers were downed by Hurricane Maria and 85 percent of above-ground and underground phone and internet cables were knocked out, so making contact with family and friends on the island is limited.

U.S. Virgin Islands

Officials in US Virgin Islands aim to have 90 percent of the territory powered by Christmas , Gov. Kenneth Mapp said in press conference Monday. The territory's power authorities have executed agreements with 40 crews in other U.S. jurisdictions, for a total of 240 linemen to help with power restoration.

Until further notice, there will be a “permanent” curfew for St. Croix beginning Tuesday, which the governor said will give residents a sense of normalcy, as well as allow businesses to operate. The curfew on St. Croix is 4:00 p.m. to 12 noon. This means St. Croix residents will be allowed to conduct their business between the hours of 12 noon and 4:00 p.m. The curfew on St. Thomas remains the same: 6:00 p.m. to 9:00 a.m.

Commercial flights will begin operating out of St. the Cyrile E. King Airport on St. Thomas on Thursday, Governor Kenneth Mapp said in a press conference. The government is aiming to reopen the St. Croix airport sometime next week, but an exact date has yet to be established.

Six airmen were deployed by the U.S. Department of Defense to work to restore communications for the islands, according to a release. They were deployed Sept. 7 and established a base of operations at the Leonard B. Francis Armory, where they set up antenna systems.

They were forced to temporarily disassemble their equipment ahead of the storm and re-establish communications after it passed.

"We had to protect our equipment in order to resume service as soon as it was over," Air Force Airman 1st Class David Zham said in the release. "We were able to bounce right back, so our mission never stopped. It was merely put on pause." Additional teams are being mobilized to support the region.

Communications were down across the islands and the local government was working to assess the damage, Virgin Islands Territorial Emergency Management Agency emergency operations supervisor Garry Green told the New York Times.

Photos and videos posted to social media out of the U.S. Virgin Islands showed major flooding on St. Thomas . On St. Croix, WTJX reporter Bob Tonge said the roads were blocked with downed wires and electrical poles.

Dominica

The Caribbean island of Dominica suffered catastrophic damage after the Category 5 hurricane slammed into the island. At least 27 people are reported dead in the wake of the storm, the island's chief of police said.

Somewhere under the rubble of 75-year-old Ashton Thomas's coastal house is one of the 27, his wife Lucy, who slipped from his grasp as they tried to escape the surge of ocean water which hurtled inside.

"I have lived here for 27 years," he told the BBC, "I never thought a storm could do this. I was holding onto Lucy with one hand and the wall with the other. I managed to get her back once but she slipped away again. If I hadn't let go, she would still be alive. How do I explain this to my daughter?"

According to Prime Minister Roosevelt Skerrit, not a single street island-wide was spared the fury of Maria's 175mph winds, which islanders described to the BBC as the sound of a "demented animal."

Images showed a once tropical paradise that is home to more than 73,000 people turned into a wasteland of crushed homes and smashed vehicles. Areas with more than 90 percent of roofs ripped off of buildings are being reported.

Supplies are being airlifted in but not

Deputy Chief Davidson Valerie told the Barbados Advocate that “many young men and ladies”, who can be called “mobs” , were seen around the city at that time, searching premises and looting.

Police Chief Daniel Carbon reported "massive looting" in several areas, but said that more than 100 officers from the surrounding islands had been brought in to help supplement the efforts of the Dominican police.

Dominican Republic

Tens of thousands were left without power in the Dominican Republic as the deadly storm swamped the country with torrential rainfall.

At least 45 of the east region’s 204 circuits were affected, which amounts to 100,000 customers. A downed power line between the towns of Playa Dorada and Cabarete has left the country's entire north coast without power.

The local Emergency Operations Center (COE) said 9,990 people were evacuated from their homes and most of the country was placed under flash flood and landslide warning, DominicanToday.com reported.

Guadeloupe

According to the Préfecture of Guadeloupe, one person was killed on the French island after being struck by a falling tree. Authorities note that the person did not heed orders to remain indoors. A second death was reported by the AP. Two people were reported missing after a boat sank near the island of La Désirade.