The road to recovery for people who live in the area will be long and arduous. Although the storm has moved out of North Carolina, it left behind damage that will take months, even years to fix.
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Officials have confirmed at least 40 deaths in Buncombe County alone. Gov. Roy Cooper said this number is likely to rise as rescue efforts continue.
Hundreds of people are still listed as missing.
The western part of the state is in ruins from destroyed homes, severe flooding, mudslides and collapsed roads. Some roads are gone making it a challenge to deliver water, food and other supplies to people.
Hospitals are running on a lifeline of their own in the form of backup power from generators as power crews work to restore electricity.
ABC11 spoke with Tissica Shoch, a Swannanoa resident, about what she saw Friday when the storm was moving through that area.
"We saw people floating down the street our neighbors floating," she said. "Two houses down they were able to get out even though the water was up to their countertops, and they caught hold of our fence and swam up our driveway."
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While most of the water has receded, crews are working to clean up the mud, debris and other damages and assess repairing roads in hopes of opening some soon.
"This is the most significant natural disaster that any one of us has ever seen in western North Carolina," Ryan Cole, Buncombe County assistant emergency services director, said.
ABC11 also spoke with Laura Shelton on Monday night. Shelton is from Burnsville, in the shadow of Mount Mitchell.
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It's an area that was decimated by Helene. Shelton lives in Houston now but spoke with ABC11 in a push to get help for her family.
"A lot of my town is gone," Shelton said. "There is no comparison."
Her family was trapped after a mudslide.
"That's what I've heard across the board from people in Burnsville. That it's complete devastation," Shelton said.
Her mom, Deborah, and her grandparents, Lois and Glenn, are still trapped with a group of neighbors near Mount Mitchell more than 72 hours after Helene brought catastrophic rain and winds to the region.
The mudslide that left those neighbors trapped, left three people dead and several homes destroyed, including that of Shelton's family, she told ABC11.
Her family members and the other neighbors need to cross a river to get to safety.
Western NC begins long journey to recovery
From Texas, she's doing what she can to help as she waits for word from first responders.
"My grandparents, who are elderly, are unable to make their way out, so that's why they really need helicopter assistance," Shelton said.
Shelton's calls for help came hours after the governor, emergency officials, and federal representatives provided an update on the recovery efforts in the mountains.
"Everyone is working together to meet the needs of the people of western North Carolina," Cooper said.
More than 300 roads remain closed and roughly 450,000 customers are still without power Monday night.
Cooper said 92 rescue teams from the federal government and several states are still working to get people to safety while air drops of supplies and food ramp up.
What we want to tell people is that more help is on the way and that help is continuing," Cooper said. "This is our main mission right now, and this is a massive coordinated effort to help this area both now and in the long term."
Shelton said Burnsville needs food, water and gasoline now, and she is desperate to see aid reach remote communities.
"This needs to be national news. There's a lot of coverage of Asheville and Boone, and their devastation is intense and terrible," Shelton said. "But there's also a lot of devastation happening in underresourced, systemically underresourced towns that need help. And they need help now."
Emergency officials acknowledged Monday that they just can't keep up with the extreme need for critical aid and supplies as well as physical rescues.
Shelton thought a helicopter might be able to get her family and neighbors out Monday, but that didn't happen.
First responders say telephone, cellphone, and internet outages make it difficult for authorities to notify victims' families.
There are more than 500 North Carolina National Guard (NCNG) members working alongside local emergency responders.
"It's been beautiful to see people come together truly," Shoch said. "I'm so proud of everyone and I'm so grateful to have people that are safe and I am so heartbroken for every person we've lost."
Helene-related road issues remained Monday, the North Carolina Department of Transportation said. Travel in western North Carolina should be for emergencies only. I-40 remains impassable in multiple locations. I-26 is closed at the Tennessee state line.
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