Struggling in death's wake

JAKARTA, Indonesia -- Rescuers battled to reach survivors in stranded villages, restore basic services, and prevent the outbreak of deadly diseases across South Asia yesterday in the aftermath of a massive undersea earthquake and subsequent tsunami that ravaged the region.

The death toll in 12 countries soared to at least 55,000, and thousands of bodies were decomposing on beaches and streets and wedged among shattered husks of trees. Survivors wandered in search of family members, hungry, at times drinking contaminated water, many not having received any help.

The World Health Organization in Geneva warned yesterday that tens of thousands of people could face death from cholera, typhoid, and other diseases.

''The initial terror associated with the tsunamis and the earthquake itself may be dwarfed by the longer term suffering of the affected communities," said David Nabarro, a physician in charge of crisis operations for WHO. ''There is certainly a chance that we could have as many dying from communicable diseases as from the tsunami."

Indonesian officials raised the estimate of the dead in their country to more than 27,000. They offered dire warnings of more destruction in outlying sections of Sumatra island, which bore the brunt of the world's strongest quake in 40 years, followed by a tsunami that crossed the Indian Ocean at up to 500 miles an hour on Sunday and laid waste to coastal areas throughout the region and in East Africa, some 3,000 miles away.

In the island nation of Sri Lanka, where the death toll reached nearly 22,000, officials said hundreds of passengers on a train appeared to have been killed in a single moment of horror. Authorities have retrieved 802 bodies and were still pulling corpses from the twisted wreckage.

In India, officials feared the death toll of more than 4,400 could rise rapidly because of devastation on the outlying islands of Andaman and Nicobar, 900 miles east of the mainland in the Bay of Bengal. Elsewhere in the region, Thailand reported more than 1,500 deaths; Burma, 90; Malaysia, 65; the Maldive islands, 52; Seychelles, three; and Bangladesh, two. In Africa, at least 110 people were reported to have perished in Somalia, 10 in Tanzania, and one in Kenya.

As relief agencies gathered donations of money, food, and supplies, aid officials said billions of dollars were required. In New York, Jan Egeland, the UN emergency relief coordinator, called for the largest appeal for global assistance since the creation of the United Nations in 1945.

The Bush administration increased its commitment to the aid effort, rejecting complaints that the US response had not been sufficient. The Agency for International Development added $20 million to an earlier pledge of $15 million to provide relief, and the Pentagon dispatched an aircraft carrier and other military assets to the region.

In Banda Aceh, the capital of Indonesia's Aceh Province, the stench of decomposing corpses was overwhelming. Bodies were strewn about, buildings were crushed, and debris covered the streets. The city, on western Sumatra island, is about 160 miles from the epicenter of the earthquake.

Red Cross workers and volunteers grimly went about the task of collecting bodies so they could be placed in a mass grave. Many were children, clad in shorts and T-shirts, their legs and arms jutting at odd angles.

''They were like frozen in action, some of them. You could see the mouth gasping, looking for air," said Andi Mallarangeng, a spokesman for President Susilo Bambang Yudhoyono, who accompanied the president on a tour of the city yesterday. ''I haven't seen anything like it before in my life."

''This goes way beyond any disaster in Indonesia since Krakatoa exploded," said Michael Elmquist, chief of the UN Office for Coordination of Humanitarian Affairs in Jakarta. He was referring to the 1883 eruption of Krakatoa, a volcano located between Sumatra and Java, believed to be the most recent event to have triggered a tsunami in the Indian Ocean.

Clean drinking water has been scarce in Aceh. Fuel is also scant, almost paralyzing transportation. Trucks are ''wiped out, stranded in trees," Mallarangeng said.

In the remote Meulaboh district of Sumatra, 80 percent of which was destroyed, a helicopter was unable to land and was forced to drop boxes of food. Officials said they feared the death toll could be particularly high there, with some reporting as many as 10,000 killed, a figure not confirmed by the government.

In Sri Lanka, victims included villagers, foreign tourists, and business people. The disaster could significantly affect the economy, which depends heavily on tourism.

Sri Lanka's east coast, which is mostly impoverished and hard to reach from Colombo, the capital, was badly pummeled. Reports of death and damage continued to trickle in yesterday from remote areas, including those still controlled by separatist rebels known as the Tamil Tigers. As many as 2,000 people may have been killed in rebel-held territory, Tamil officials said. Both sides have refused to work together despite the massive humanitarian crisis.

In the eastern district of Trincomalee, waves killed at least 850 people, according to D.S. Arumainayaham, the official overseeing relief efforts. He said the seawater contaminated much of the city's water supply and displaced about 25,000 people.

In the southern part of Thailand, local people used shovels and saws to try to reach survivors and the dead. Residents and tourists complained about the slow pace of relief. In an interview in Phangnga Province, the hardest-hit section of the Southeast Asian country, Deputy Prime Minister Chaturon Chaisang acknowledged that rescue efforts had been slow.

''It has not been very well organized yet because of terrible communication," Chaturon said.

One resident, Supasate Opitakon, 30, three of whose friends were killed when they were swept off the beach, said the army could have done more to help.

''In America, you use helicopters to save even an animal," he said. ''Here there were so many people needing help and so few helicopters."

There were reports from India's Andaman and Nicobar islands, a remote archipelago off the coast of Burma, that the toll could reach at least 7,000. The Press Trust of India news agency quoted police officials as saying that four relief ships had been sent to Great Nicobar, one of the largest of the islands, but two could not anchor because the sea was too rough.

On India's hard-hit east coast, loudspeakers warned against drinking contaminated water and health officials said they feared an epidemic of disease.