Five adults and five children drowned in their homes or were swept to their deaths as Ike's driving rains hit Haiti, raising that country's death toll to 262 from four tropical storms in recent weeks. It was too early to know of deaths on other islands where Ike's most powerful winds were still blowing Sunday morning.
With downpours from Ike topping flooding from Hanna, Gustav and Fay, officials said they had no choice but to open an overflowing dam, inundating more homes and possibly causing lasting damage to Haiti's "rice bowl," a farming area whose revival is key to rescuing the starving country.
Ike's eye hit the Bahamas' Great Inagua island, where screaming winds threatened to peel plywood from the windows of a church sheltering about 50 people, shelter manager Janice McKinney said.
"Oh my God, I can't describe it," McKinney said, adding that the pastor led everyone in prayer while the winds howled.
Some of the strongest winds hit the low-lying British territory of Turks and Caicos, where Premier Michael Misick said more than 80 percent of the homes were destroyed, fishermen lost boats and people who didn't take refuge in shelters were cowering in closets and under stairwells, "just holding on for life."
"They got hit really, really bad," Misick said. "A lot of people have lost their houses, and we will have to see what we can do to accommodate them."
At 11 a.m. EDT, Ike's eye was just east of Great Inagua Island in the southeastern Bahamas, with maximum sustained winds of 135 mph. It was moving west at 13 mph (21 kph) and was expected to remain a major hurricane as it approaches eastern Cuba, still about 130 miles away.
"All we can do is hunker down and pray," reserve police officer Henry Nixon said from a shelter on Great Inagua where about 85 people huddled around a radio.
Great Inagua, closer to Haiti than to the Bahamian capital of Nassau, is the southernmost island in the Bahamas archipelago. It has tens of thousands of pink West Indian flamingos - the world's largest breeding colony - and about 1,000 people. Both populations took shelter - the pink flamingos gathered under mangrove trees ahead of the storm.
"They know what to do. They always find the sheltered areas," Nixon said Sunday as Ike blew shingles off rooftops.
Rain drove in horizontal sheets and wind tore through roofs across the Turks and Caicos, which has little natural protection from an expected storm surge of up to 18 feet (5.5 meters).
In South Caicos, a fishing-dependent island of 1,500 people, most homes were damaged, the airport was under water, power will be out for weeks, and every single boat was swept away despite being towed ashore for safety, Minister of Natural Resorces Piper Hanchell said.
Tourism chairman Wayne Garland was text-messaging with two people in Grand Turk during the height of the storm. "They were literally in their bathroom because their roofs were gone," he said. "Eventually they were rescued."
In Providenciales, there was flooding, roof damage and downed power lines but no injuries, he said.
"Fortunately, we were able to evacuate most of the people in low-lying areas to shelters, so thankfully I don't expect to have any injuries. We'll keep our fingers crossed that that's the case," Garland said as he left to assess the damage.
Ike's pelting rains couldn't have come at a worse time for Haiti. The Mirebalais bridge collapsed in the floods, cutting off the last land route into Gonaives, Agriculture Minister Joanas Gay told state-run Radio Nationale. Half the homes in Gonaives, Haiti's fourth-largest city, were already under water.
Gay warned residents in the surrounding Artibonite valley to evacuate immediately because an overflowing dam would have to be opened on Sunday, sending more water into the Gonaives floodplain. And in Gonaives itself, the waters were rising even as aid groups struggled to reach people with little or no access to food or water for days.
Heavy rains also pelted the Dominican Republic, Haiti's neighbor on the island of Hispaniola, where about 4,000 people were evacuated from northern coastal towns.
The U.S. National Hurricane Center projected Ike's eye would strike Cuba's northern coast Sunday night and possibly hit Havana, the capital of 2 million people with many vulnerable old buildings, by Monday night.
Cuba evacuated mountainous and coastal regions of Holguin province, and about 200 foreign tourists were brought out from the northern Santa Lucia beach resort. Workers rushed to protect coffee plants and other crops and organized food and cooking-oil distribution efforts.
At the U.S. naval base at Guantanamo Bay in southeast Cuba, all ferries were secured and beaches were off limits. The military said cells containing the detainees - about 255 men suspected of links to the Taliban and al Qaeda - are hurricane-proof.
"People have been forewarned for a day," Navy Petty Officer 1st Class Robert Lamb said. "It's starting to get breezy."
Once Ike leaves Cuba, forecasters said the storm might swipe at the Florida Keys before moving into the Gulf of Mexico. Where it goes from there was harder to predict, leaving millions from Florida to Mexico wondering where it will eventually strike.
"These storms have a mind of their own," Florida Gov. Charlie Crist said. Tourists were ordered out of the Keys on Saturday, and residents began evacuating Sunday, starting with the southernmost islands, along the narrow highway to the mainland.
In Louisiana, Gov. Bobby Jindal set up a task force to prepare for more possible havoc only days after an historic, life-saving evacuation of more than 2 million people from Hurricane Gustav.
"Our citizens are weary and they're tired and they have spent a lot of money evacuating," worried New Orleans Mayor Ray Nagin. "It will be very difficult to move the kind of numbers out of this city that we moved during Gustav."
Off Mexico's Pacific coast, Tropical Storm Lowell was moving away from land.
By Associated Press writer Mike Melia in Nassau, Bahamas; the QAP's Jonathan Katz in Gonaives, Haiti; and Danica Coto in San Juan, Puerto Rico, contributed to this report.