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Hours before the storm, the government said it had done all it could to prepare as it warned of catastrophic damage.

“There is no infrastructure in the region that can withstand a Category 5,” Prime Minister Andrew Holness said. “The question now is the speed of recovery. That’s the challenge.”

Landslides, fallen trees and numerous power outages were reported ahead of the storm, with officials in Jamaica cautioning that the cleanup and damage assessment would be slow.

A life-threatening storm surge of up to 13 feet (4 meters) is expected across southern Jamaica, with officials concerned about the impact on some hospitals along the coastline. Health Minister Christopher Tufton said some patients were relocated from the ground floor to the second floor, "and (we) hope that will suffice for any surge that will take place.”

The storm already was blamed for seven deaths in the Caribbean, including three in Jamaica, three in Haiti and one in the Dominican Republic, where another person remains missing.

Jamaica braces for catastrophic damage

Melissa was centered about 150 miles (240 kilometers) southwest of Kingston and about 330 miles (530 kilometers) southwest of Guantánamo, Cuba. The system had maximum sustained winds of 175 mph (280 kph) and was moving north-northeast at 2 mph (4 kph), according to the U.S. ��ɫtv Hurricane Center in Miami.

“We will get through it together,” said Evan Thompson, principal director at Jamaica’s meteorological service.

Colin Bogle, a Mercy Corps advisor based near Kingston, said most families are sheltering in place despite the government ordering evacuations in flood-prone communities.

“Many have never experienced anything like this before, and the uncertainty is frightening,” he said. “There is profound fear of losing homes and livelihoods, of injury, and of displacement.”

Matthew Samuda, Jamaica’s water and environment minister, said he had more than 50 generators available to deploy after the storm, but warned people to set aside clean water and use it sparingly.

“Every drop will count,” he said.

Melissa takes aim at Cuba

Melissa also was expected to make landfall in eastern Cuba late Tuesday as a powerful hurricane.

A hurricane warning was in effect for Granma, Santiago de Cuba, Guantánamo and Holguin provinces, while a tropical storm warning was in effect for Las Tunas. Up to 20 inches (51 centimeters) of rain were forecast for parts of Cuba, along with a significant storm surge along the coast.

Cuban officials said Monday that they were evacuating more than 600,000 people from the region, including Santiago, the island’s second-largest city.

Melissa also has drenched the southern regions of Haiti and the Dominican Republic, with a tropical storm warning still in effect for Haiti.

The hurricane was forecast to turn northeast after Cuba and strike the southeast Bahamas by Wednesday evening.

A hurricane warning was in effect for the southeastern and central Bahamas, and a tropical storm warning was issued for the Turks and Caicos Islands.

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Coto reported from San Juan, Puerto Rico.