Florida, March 28: For the past 10 weeks, Evans Monsignac has struggled to understand how and why he is still alive. So remarkable is his survival, that at times it has been easier for him to think that he must in fact be dead.

Severely malnourished, dehydrated, deeply traumatised and with festering wounds, the frail slum-dweller’s survival was hailed a miracle when he emerged after an extraordinary 27 days, trapped in the ruins of Haiti’s earthquake, confounding doctors and defying medical logic. It is believed to be the longest anyone has endured such an ordeal.

Now recovering in a US hospital, he has spoken for the first time of his ordeal.

“I still don’t understand how I’m here,” he admitted, his skeletal body resting limply in an intensive care bed at Tampa General Hospital, Florida. “I was resigned to death. But God gave me life. The fact that I’m alive today isn’t because of me, it’s because of the grace of God. It’s a miracle, I can’t explain it.”

Monsignac, 27, a father of two, was the last person found alive under the debris after an earthquake levelled Port-au-Prince on January 12. His relatives say someone, they do not know who, came across him while working through the rubble on February 8 and rushed him, delusional and rambling, to an emergency clinic.

Even his name was a mystery, variously recorded by medics as Evans Monsigrace, Evans Muncie and Evan Ocinia. A plastic hospital bracelet on his bony left wrist spells it out correctly now.

Countering speculation that he must have had access to food and clean water while trapped, he shook his head. “No,” he said emphatically, and no one else was involved in his epic struggle for survival; just himself and God. He was pinned by concrete slabs, saw nobody and heard only the screams of the dying. “I had no contact with anybody. None,” he insisted.

The appalling reality, he said, is that he survived by sipping sewage that oozed underneath the rubble of the marketplace where he was buried, a place where sanitation was lacking even before the earthquake.

“It was trickling past where I was lying. I felt it under my body,” he saids. He shifted his right arm weakly on the bed, turning his empty palm upwards and forming it into a scoop before raising it towards his mouth to demonstrate how he collected and drank the foul liquid.

Even before the earthquake struck, killing an estimated 230,000 people, life had been a struggle for Monsignac, a dirt-poor market vendor who scratched a living selling rice and cooking oil.

On the day disaster struck, he had woken at 5am at his home in Portail St-Joseph — a slum — and caught a bus to La Saline marketplace.

“As soon as I finished selling the last batch of rice the earthquake happened. Suddenly things were just flying all over and flattening me,” he recalls. “I said ‘Oh Lord, I’m dying.’ I tried to turn to the right, but I was pinned down by rock, I tried to turn to the left, I was pinned down with rock.”

Looking up, he saw a slab of debris thundering towards him as buildings collapsed on the market. “A piece of concrete was falling to my face but then it was like someone came and pulled it back. I don’t know if it was God,” he said.

“This piece just stopped above me. But still I couldn’t move. I heard so many screams all over, people screaming loudly. I just lifted up my eyes and prayed because I couldn’t understand what was going on.”

The exact details of what happened over the next 27 days remain a mystery, registering as only a blur in Monsignac’s traumatised mind as he drifted in and out of consciousness, losing all concept of time.

“I was lying on my back. I was so scared because if I turn one way I will get hurt and if I turn another way I get hurt. If I move it will bring death. So I lay straight,” he said.

“I didn’t think of anything, just death. I could smell death from others — there were a lot of people under the rubble with me but the screaming was one day only. Then it was quiet. It was dark all the time. Every time I came out of consciousness I prayed, I prayed that God would rescue me.

“I thought I was dead. I was in shock. On the second day, maybe the third day, I realised I seemed to be alive and I saw this water. I was hungry and thirsty and I tried to drink something but it was making me sick in my belly. I would take my little finger and wet my lips and swallow it, but the sicker I got as time went on.”

He recalls nothing of his rescue, of feeling the sunlight on his face for the first time in nearly a month.

His lanky frame is stick thin — he weighed just 40kg when he was admitted, having shed 27kg during his ordeal — and his bones bulge below his papery brown skin. His right forearm bears deep red sores, and his fingernails are stained with dried blood from scratching at them. His eyes are lifeless and he stares blankly at a television.

Despite being severely dehydrated when he was found, his survival without any damage to his kidneys is considered remarkable.

Monsignac likes chocolate milk and had just nibbled a piece of toast and a boiled egg, but has mostly been rejecting food. He is still “desperately malnourished”, said his doctor,” Smith explained.

He is also suffering from post-traumatic shock, sometimes melting down into fits of screaming. He periodically moans and turns his head on the pillow, calling to nurses for more painkillers, or drawing his blanket over his head and retreating.