Haiti struggles to provide its nearly 11 million residents with basic shelter. How can it protect them from the punishing winds and calamitous aftereffects of Irma?

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“I guess we are worried, but we are already living in another hurricane, Hurricane Misery,” said Nadeige Jean, a 35-year-old mother of three who was selling fruit at the Olympic Market in the capital city. “How much worse can our lives get? … So they say I should board up my house? With what? Wood? Who’s going to pay? With what money will I buy it? Ha! I don’t even have a tin roof. If the winds come, I can’t do anything but hope to live.”

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Irma's toll could be felt long after the wind and rain are gone. If infrastructure collapses after the storm, another major concern will be the potential resurgence of a cholera outbreak that has already killed thousands.

On Thursday, Haiti raised its hurricane alert level to red, its highest. The flood-prone north coast remained under a hurricane watch and the central coast faced the threat of tropical-storm-force winds and rain.

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Nevertheless, aid groups worry that the national hurricane response was too slow.

“Hurricane Irma could be a monster storm in Haiti, particularly on the heels of Hurricane Matthew’s deadly destruction in the southern part of the country just last October,” warned Karl Paul, Care Haiti’s country director.

Many evacuations in the north had not been completed as Irma's first rains began to pelt the island. Low-quality shelters remain incomplete.

National warnings went out through social media, radio and television, but in some remote towns, the official word to take shelter was being spread largely via bullhorn.

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A preview of the potential devastation lay to the east, where the island of Barbuda was left “barely habitable,” according to Antigua and Barbuda Prime Minister Gaston Browne. Following a flyover of his devastated Caribbean country, Browne estimated that 95 percent of all properties were destroyed. Parts of the 62-square-mile island, he said, were “literally underwater.”

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All that despite his statements earlier that “no other country in the Caribbean would have been as well prepared as we were.”

Seven hundred miles away, in Haiti, the shelter situation is dire.

According to Amnesty International, more than 123 camps for people displaced by the earthquake remained open in 2014, housing more than 85,000 people. A third of those didn't have access to a latrine, and an average of 82 people shared one toilet.

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By 2015, about 37,000 houses had been repaired or rebuilt after the earthquake, but only 20 percent of those were “seen as long-term, or sustainable,” Amnesty International said.

Down the narrow paths of Cite Soleil, a teeming slum by Port au Prince Bay, Odelin Joseph, a 29-year-old rapper, fell through his aluminum roof late Thursday while trying to mend it in preparation for Hurricane Irma.

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He said he and other residents in capital's largest slum were afraid. The gutters and allies of the city’s largest slum flood easily, he said, even during moderate downpours.

“We have not seen any local authorities who came to visit us since they announced the storm was coming,” he said. “Many people here, they do not know where shelters are. And when it rains here, it floods.”

And Irma may not only destroy homes and businesses, but it could also cripple Haitians' ability to rebuild.

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Forty percent of Haitians depend on the agricultural sector, “mainly small-scale subsistence farming, which remains vulnerable to damage from frequent natural disasters,” according to the CIA World Factbook.

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“I don’t have words to describe this. We go from one crisis to another. I am speechless,” said Edwitch Gabriel, a hairdresser stocking up on powdered milk and other supplies at the Olympic market.

In one sense, Haiti’s series of major disasters gave the nation at least one benefit: an already large presence of international aid groups that would be part of a rebuilding effort.

Many groups said they were poised with teams and vehicles to help bring in medical and food aid. Care International’s emergency teams, for instance, were on the ground, readying to bring in clean drinking water, food and emergency supplies, including tarps for shelter.

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Providing aid could be harder because the country is still dealing with the effects of Hurricane Matthew, said Ronald Tran Ba Huy, director of the United Nations' World Food Program in Haiti.

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Huy said he had already received reports of flooding because of Irma on the Haitian coast east of Cap-Haïtien, and he expected worse to come.

“This is too big and too soon after Hurricane Matthew last year; parts of the country are still recovering,” he said. “We’re expecting major floods from heavy rains in the north. The whole northern coast will be affected; as many as 2.2 million people.”

As the hurricane neared, Jean, the fruit seller, was one of the people worried about the flooding. If heavy rains came, she might not be able to sell her stock of produce.

“I bought this on credit to sell here, and if I can’t sell it, I’m finished,” she said. “But we are always living like this here, just one step away from disaster. We get used to it.”

Wootson reported from Washington.