Close to 60% of Haiti’s capital is dominated by gangs whose violence and sexual attacks have caused thousands to flee their homes, the UN humanitarian chief in the Caribbean nation has said.

Ulrika Richardson said that has left nearly 20,000 people in Port-au-Prince are facing “catastrophic famine-like conditions” as a cholera outbreak spreads throughout Haiti.

Ms Richardson painted a grim picture of a country in a downward spiral, with half its population in urgent need of food assistance as the number of cholera deaths has risen to 283.

The UN official said close to 12,000 people have been taken to hospital with the disease since October 2, and there are now a total of more than 14,000 suspected cholera cases in eight of the country’s 10 regions.

She said all but 1,000 of the 20,000 Haitians facing starvation are in the capital, Port-au-Prince, mainly in the Cite Soleil slum controlled by the gangs.

Ms Richardson said insecurity has led to “massive displacement,” especially in the capital, where 155,000 people have fled their homes.

She said at a news conference that the gangs are using “very terrifying levels of sexual violence as a weapon” to keep people under control, instil fear and punishment.

Ms Richardson said gang battles over territory and their criminal actions are tearing society apart and escalating insecurity.

Political instability has simmered in Haiti since last year’s still-unsolved assassination of President Jovenal Moise, who had faced protests calling for his resignation over corruption charges.

Daily life in Haiti began to spin out of control in September just hours after Prime Minister Ariel Henry said fuel subsidies would be eliminated, causing prices to double.

A gang led by Jimmy “Barbecue” Cherizier, a former police officer, blocked the Varreux fuel terminal, setting off a fuel crisis.

The UN Security Council imposed sanctions on Mr Cherizier on October 21, and he announced on November 6 that his G9 gang federation was lifting the blockade.

But despite the availability of fuel, Ms Richardson said, the humanitarian, security and political situation is worsening, saying that “everyone is affected by the violence”.

Mr Henry and Haiti’s council of ministers sent an urgent appeal on October 7 calling for UN Secretary-General Antonio Guterres to dispatch an international military force to tackle Haiti’s violence and alleviate its humanitarian crisis.

Ms Richardson said UN Security Council members have held intensive discussions since then, focusing on the “potential leadership and potential composition of such a force”, but so far there has been no decision.

“What is very important here is that the gang violence needs to be addressed,” she said.

While discussions are continuing in the Security Council, Ms Richardson said the United Nations and a lot of countries are helping Haiti’s national police force – “and they need a lot of support in terms of equipment and training”.

In mid-November, the UN launched an emergency appeal for 145 million dollars (£118 million) to respond to Haiti’s cholera outbreak and rising hunger, but so far it has received just 23.5 million dollars (£19.2 million), she said.

Ms Richardson said the UN will be appealing for 719 million dollars (£589 million) for Haiti for 2023, double the amount this year, because of the dramatic deterioration of the humanitarian situation.

On a positive note, she said, schools are being reopened at the level of about 53% throughout the country, mainly in the south.

Many of the four million children in Haiti have not had any proper education since the beginning of the Covid-19 outbreak in March 2020, she said.