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It killed 68 people and left a trail of destruction across the Caribbean -- thousands of homes torn apart, vast areas flooded and life paralyzed on islands where gargantuan recovery efforts lie ahead. But Hurricane Ivan (search) skirted most big cities, and the devastation could have been far worse.

One of the strongest storms on record, Ivan swept through nine countries and the wealthy British territory of the Cayman Islands (search) before spinning Tuesday into the Gulf of Mexico. The hurricane claimed victims even on its fringes, in Venezuela and Dominican Republic. From 200 miles away, it brewed up a gigantic wave that drowned four children on a beach in the Dominican capital, Santo Domingo.

Ivan made an especially damaging direct hit last Thursday on Grenada (search), leaving 60 percent of the already impoverished country homeless and many victims in dire need of food and drinking water.

Even on islands with no reported deaths, such as the Caymans, Ivan left thousands homeless.

"This is going to set people back right through the Caribbean," said Weston White, 35, a Jamaican whose seaside home east of Kingston had waves crash into it, sucking out furniture and leaving three feet of sand.

"It's going to be a long time before we recover from this," White said, trying to salvage a soaked mattress and stereo speakers from his house. "Right now we need some help from the government, or a lot of people are going to be sleeping on the street."

The storm reached far into the southeastern Caribbean, hitting countries rarely affected, including Barbados and Trinidad, which is normally used as a refuge by yachters in hurricane season. Ivan was Grenada's first hurricane in 50 years, Grenadian Prime Minister Keith Mitchell said Tuesday.

But many big cities were spared the worst of the storm.

That was especially true in Cuba, where the storm initially was forecast to hit Havana, the country's capital and home to 2.2 million, with catastrophic strength. Instead, it only grazed the island's sparsely populated westernmost tip Monday night. Cuba's Civil Defense said there were no deaths or injuries on the island, where the government evacuated 1.9 million of the 11.2 million people.

On Sunday, Ivan was expected to make a direct hit on George Town but stayed out at sea, passing just 30 miles south of the Cayman Islands' capital.

A track that would have had Ivan smashing into southeastern Jamaica near the capital, Kingston, and exiting near the northwestern resort of Montego Bay changed on Saturday, the day the storm arrived. Ivan stalked Jamaica's southern shore but never made a direct hit.

Still, the slow-moving storm killed at least 39 people in Grenada, including three children, 15 in Jamaica, five in Venezuela, one in Tobago, one in Barbados and three in Haiti.

For hurricane survivors on many islands, the situation was desperate.

An estimated 90 percent of Grenada's homes were damaged or destroyed, and there were severe shortages of food and drinking water. As many as 60,000 people are homeless in the country of 100,000, said Solveig Olafsdottir, spokeswoman for the International Federation of Red Cross and Red Crescent Societies.

The Geneva-based agency has distributed a 22-ton relief shipment of plastic sheeting, fuel, generators and other supplies to 3,000 families in Grenada.

"There isn't a single community that has been spared," Olafsdottir said. "The question now is where to start."

On the Cayman Islands, up to half of Grand Cayman's 15,000 homes appeared to be uninhabitable in the short term, leaving thousands homeless, said Pilar Bush, the territory's tourism director.

Yachts were tossed ashore, century-old trees were snapped or uprooted and well-built homes reduced to splintered wood across Grand Cayman, a banking center and popular scuba diving destination.

Widespread destruction was visible from an airplane chartered by The Associated Press that flew over the island Monday, a day after Ivan struck. On the island's Seven Mile Beach, one hotel was partially smashed, with rooms gaping open to the sea, and others had no roofs.

Sailors from the British navy frigate HMS Richmond came ashore on smaller boats Tuesday to see how they could help, officials said.

In Jamaica, some communities remained inaccessible because of landslides and blocked roads. Officials airlifted food and supplies to remote areas where stockpiles at shelters were running low.

About 19,000 of the country's 2.6 million people were in shelters and most of the island was without electricity or running water, said Nadene Newsome, of Jamaica's emergency management agency.

"The majority of homes across the island have suffered roof damage," Newsome said.

Hotels and restaurants in Jamaica's northwestern resort town of Negril suffered major damage when Ivan brushed that island's southern coast early Saturday, unleashing waves as high as 30 feet, along with torrential rains and fierce winds.

Ivan also ravaged vegetable crops in western Jamaica and damaged seaports used to ship bauxite and aluminum, among the island's chief industries.

Residents in Cuba's provincial capital of Pinar del Rio, who had been terrified by the images from other islands, were surprised to find minimal damage on Tuesday, after the storm passed.

"We are so happy that hardly anything happened here," said 37-year-old Zoraida Marrero as she returned home with her family.

A government helicopter flight over the region showed dozens of tobacco curing houses with sides or roofs torn away. Crops weren't damaged because the planting season hadn't yet begun.

On Cuba's southwestern coast, damage was more pronounced as heavy waves erased the beach along the fishing village of Playa Las Canas.

Roofs were torn from some modest wooden homes and knee-level water flooded seaside structures, which were empty because of mass evacuations. In agricultural areas, groves of banana trees were flattened.

Cuban Civil Defense Lt. Angel Macareno said Tuesday night on state-run television that it was still too early to estimate damages.

Meanwhile, more threats could lie ahead before this particularly active hurricane season ends Nov. 30.

Tropical Storm Jeanne, which became the 10th named storm of the season on Tuesday, threatened to strengthen into a hurricane, prompting hurricane warnings in Puerto Rico and the U.S. Virgin Islands.

Off western Mexico, forecasters were watching Hurricane Javier, a Category 4 storm on a northwest course out to sea. Forecasters said it was possible the storm could make a sharp turn toward the southern Baja California peninsula.