The problems in Haiti may be summed up by the public hospital in L’Asile, deep in a remote stretch of countryside in the nation’s southwest area. Here, a full four days after a powerful earthquake hit this region the hardest, people are still showing up from isolated villages with broken arms and legs.

Hospital director Sonel Fevry said five such patients showed up Tuesday, the same day officials raised the disaster’s death toll by more than 500. Grinding poverty, poor roads and faith in natural medicine all conspire to make the problems worse.

“We do what we can, remove the necrotized tissue and give them antibiotics and try to get them a splint,” Fevry said, adding that road access to the facility in the department of Nippes is difficult and not everyone can make it.

Haiti’s Civil Protection Agency increased the number of fatalities from Saturday’s earthquake to 1,941. It also raised the number of injured to 9,900, many of whom have had to wait for medical help lying outside in wilting heat and riding out a storm Monday night that brought heavy rains and wind gusts.

The countryside was worse hit by the quake, perhaps, than the cities, but news is only slowly trickling out. The whole obstetrics, pediatric and operating wing at the L’Asile hospital collapsed, though everyone made it out. Despite the collapse, the hospital was able to treat about 170 severely injured quake victims in improvised tents in the facility’s yard.