Video from the International Space Station shows just how massive Matthew is. The storm is unleashing winds up to 145 miles an hour.

Meanwhile, drenching rains are also underway, along with a dangerous storm surge.

"As we know, we're not really prepared for this type of hurricane," one resident said. "But we're doing the best that we can."

So far, Matthew has killed at least four people across the Caribbean.
Workers at one orphanage boarded up windows and moved more than 60 children to the second floor.

"We're preparing for the worst and praying for the best. This could be a very bad storm from what we hear," Love Pun, operations manager at the Be Like Brit Orphanage, told West Palm Beach's NewsChannel 5.

Forecasters are warning that more than three feet of rain could hit parts of Haiti, triggering deadly mudslides. It was just six years ago that a disastrous earthquake struck the island nation and there's great concern about many people still living in makeshift shelters.

The storm also poses another deadly threat in the form of disease.

"Unfortunately, the storm is going to kill people twice. It is going to kill them now with the wind and the water and the initial impact of it, but within the next couple of weeks as the flood waters recede it is going to leave disease behind it—a tsunami of death," Operation Blessing’s Bill Horan warned.

A cholera outbreak hit Haiti hard after the 2010 earthquake.  Operation Blessing responded then with chlorine and safe drinking water and it's doing so again.

"Thousands of people have died.  Hundreds of thousands of people have suffered from this cholera," Horan said.  

"So what we started doing five years ago is manufacturing chlorine, chlorine that we typically use to disinfect drinking water," he explained. "But in times like this we will be using it for surface disinfection." (Screengrab via CBN News)

Matthew is moving at just seven miles an hour, which makes it even more dangerous. The storm is advancing over Haiti Tuesday and is expected to make landfall in eastern Cuba as well—about 50 miles east of the U.S. Navy base at Guantanamo.

Matthew will then likely move north through the Bahamas, and it may make landfall in the U.S. later this week.

In Florida and North Carolina, authorities are taking no chances.  The governors there have already declared states of emergency.

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