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Hurricane Idai had a "mbadive and horrible" impact on the port city of Beira in Mozambique, said the Red Cross.
He touched down Thursday with winds reaching 177 km / h (106 mph), but rescue teams reached only Beira Sunday.
People were saved from the trees, houses were destroyed and roofs were destroyed, BBC head of the Red Cross badessment team Jamie LeSeur told the BBC.
The hurricane killed at least 150 people throughout southern Africa.
More than 80 people have died in eastern and southern Zimbabwe, said Nick Mangwana, director of the Ministry of Information, at the Reuters news agency.
This includes two students from St Charles Lwanga boarding school in Chimanimani district who died after their dormitories were hit by rocks swept by a mountain.
Malawi has also been hit hard. The floods that occurred there, caused by the rains that preceded the hurricane's landing, killed at least 122 people, reports Reliefweb.
What is the extent of the damage to Beira?
At least 68 people have died in Mozambique, mainly around Beira, local authorities said.
More than 1,500 people have been injured by falling trees and building debris, including a zinc roof, BBC chief Jose Tembe told Maputo, quoted by officials.
"Almost everything has been touched by the disaster," said Alberto Mondlane, governor of Sofala province, on Sunday, which includes Beira.
"We have people who are currently suffering, some at the top of the trees and in dire need of help."
The population of Beira, which has a population of 500,000, has made an "incredible effort" to reopen the city's roads, LeSeur told the BBC's Newsday program.
"Beira has been severely beaten, but we hear that the situation outside the city could be even worse," said a statement from the International Federation of Red Cross and Red Crescent Societies.
The port city of Beira has been hit hardest by the cyclone
The road connecting Beira to the rest of the country has been damaged, but air links have now resumed.
President Filipe Nyusi has shortened a trip to eSwatini, formerly Swaziland, to visit the affected areas.
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