By JENNIFER LEBOVICH, TRENTON DANIEL AND JACQUELINE CHARLES

The aerial view for Haiti's newly installed prime minister was brutal Tuesday: a storm-ravaged landscape stretching out for miles, flooded rice fields, washed-out cities and survivors battling rivers of mud.

But as Michèle Pierre-Louis surveyed the damage from a U.S. military chopper, three days after a fourth storm buffeted Haiti, she knew that the areas out of view -- remote communities hidden by mountains and cut off by impassable roads -- were likely worse off.

''It's very shocking,'' said Pierre-Louis, who officially took charge of Haiti's government Friday. "It's very hard to see that people are now living on their roofs, and that is the only way they can survive.''

From Haiti to Turks and Caicos and the Bahamas, Caribbean leaders surveying the devastation by air and land echoed a similar call: We need help.

''People are desperate for food, for drinkable water,'' Pierre-Louis said. "This is the most urgent need.''

As Pierre-Louis joined U.S. Ambassador Janet Sanderson for an overview of the affected region, U.S. military aboard a Navy hospital ship anchored off the coast of Port-au-Prince, U.N. peacekeepers and aid groups battled logistical issues to get sorely needed tarps, food and water to storm victims.

The four-storm death toll in Haiti was officially upgraded to 341.

In Cabaret, where 57 died when Ike struck Sunday, some help finally arrived Tuesday. Water trucks dispersed through the town, and a church group provided warm meals of beans and rice and spaghetti out of a pickup truck. People ate with whatever they could find -- baseball caps, leaves from fallen banana trees.

Concerned about the possibility of more deaths, Pierre-Louis said the government was seeking to declare a state of emergency, and looking for temporary ''war'' bridges to reconnect critical routes and get to those still stranded.

The prime minister said the priority was ``evacuating people from the dangerous zone, bringing food, bringing water, bringing medical supplies and making sure that it goes to the beneficiary and not diverted by criminal hands.''

In the northwestern port city of Gonaives, aid flights were not able to land and U.S. Navy personnel were forced to take 186,862 pounds of food into the city by sea because the ship's gigantic MH-53 Sea Stallion helicopters are too big for the tiny airstrip. The choppers, capable of carrying 11,000 pounds of food, were sent to Les Cayes, the flood-prone southern city cut off from the capital by an overflowing river.

''This is going to pick up and progress every day,'' Mission Commander Fernandez ''Frank'' Ponds told Pierre-Louis as he showed her the ship's relief operation. More than 500 personnel have been loading and unloading food and preparing tens of thousands of gallons of water aboard the ship. A few miles north of Haiti, Bahamas Prime Minister Hubert Ingraham and Turks and Caicos Premier Michael Misick were surveying damage caused by Ike.

On the tiny Bahamian island of Great Inagua, dozens of locals showed up to meet Ingraham, who visited schools and other buildings damaged in the storm.

''We came here to see what relief they'll bring,'' said Dennis Seymour, 44, a construction worker.

The island's lone settlement, Matthew Town, took a pounding from Ike. None of the 1,000 residents died, but churches lost steeples, homes were stripped of shingles and walls and telephone poles were knocked to the ground.

The town is now without power or running water, and officials estimate the damage at $5 million.

Mayor Allan Clare estimated the town would run out of water in two to three weeks.

Bahamian government officials said Tuesday some 1,300 gallons of water were delivered via airplane over two days and a generator was en route. Ingraham told The Miami Herald his priority was ``to make homes safe by covering the roofs, to ensure there's a continuous supply of fresh water.''

After his two-hour visit, Ingraham boarded a U.S. Coast Guard helicopter for the nearby island of Mayaguana and then Grand Turk, capital of neighboring Turks and Caicos Islands. On Grand Turk, Ingraham and Misick found devastation.

At the international airport, the fire station's roof was peeled back and its contents strewn about. The island's narrow streets were littered with broken glass and shingles. Houses stood with no roofs.

''This is the most significant disaster we've had in modern history,'' Misick said. ``But Providenciales and Parrot Key, the major tourism sites, are unaffected and open for business.''

By the time Ike bore down last week, the string of islands had already been soaked by Tropical Storm Hanna, which battered the tiny British dependent territory for days, flooding streets and tearing off shingles.

''That was a lot of water, a lot of rain. We got hit twice,'' said Misick, who flew in a 19-seater from Providenciales over South Caicos and then landed in Grand Turk. As the plane flew over South Caicos, Misick pointed to the flooded roads in the tightknit fishing community where horses still run wild at night. A British warship with supplies sat off the island's coast.

Aid was slowly trickling into Turks and Caicos. The Red Cross had delivered canned food, water and other supplies. The British Navy delivered water, crackers, packages of soup and peanut butter.

But people still need more food and water -- and temporary shelter, said Misick, estimating it would cost several hundred million dollars to rebuild the islands and replace an important causeway linking Middle and North Caicos.

That there was no loss of life on either island, Misick said, ''is a miracle itself.'' But the extensive damage was still hard to bear.

''It's discouraging, depressing,'' said Robert Newman, 39, standing next to a makeshift stove as a pot simmered with pork shoulder.

Newman's house, built just a few years ago, held up well, save for a few leaks. Now it was home to 13 of his family and friends, homeless after the storm.

``It's almost like everything is gone.''