Humanitarian groups and governments around the world yesterday launched the largest relief effort in history in a desperate race to save thousands of survivors of Sunday's earthquake-driven...

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WASHINGTON — Humanitarian groups and governments around the world yesterday launched the largest relief effort in history in a desperate race to save thousands of survivors of Sunday’s earthquake-driven tsunamis from a new threat: deadly diseases.

The catastrophe — spanning five time zones, 12 countries, three civil wars and thousands of miles of ocean — had killed as many as 68,500 by last night, according to reports. Twelve Americans were among the dead, and scores were missing. Health experts warned that illnesses linked to contaminated water, poor sanitation and cramped living conditions could add tens of thousands of victims to the death toll.

“Tragic as it is, for the … dead, there’s nothing we can do for them now,” said Ed Fox, assistant administrator for the U.S. Agency for International Development. “The real tragedy at the moment is if we don’t do things to prevent further deaths from the spread of epidemics or communicable diseases.”

The magnitude of the disaster spawned by the magnitude-9.0 earthquake overwhelmed relief agencies.

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“It is in a class by itself completely because of the sheer scope of the disaster, the area covered, the number of countries and the sheer suddenness of it,” said Arjun Katoch, a senior disaster-relief specialist with the United Nations in Geneva.

World Health Organization officials urged survivors to shift their focus from dealing with the dead to protecting the living from gastrointestinal illnesses, malaria, respiratory infections, dengue fever and other maladies that stem from unsanitary living conditions.


Tsunami death toll





Indonesia:
At least 32,502, all on the island of Sumatra. The Health Ministry said the figure did not include districts on Sumatra’s hard-hit western coast, meaning the final toll almost certainly will increase significantly.


Sri Lanka:
21,715 in government- and rebel-controlled areas.


India:
Nearly 12,500 confirmed, including at least 7,000 on India’s remote Andaman and Nicobar islands, north of Sumatra.


Thailand:
1,516, including more than 700 tourists.


Somalia:
At least 110.


Myanmar:
About 90, according to international aid agencies.


Malaysia:
At least 65, including foreigners.


Maldives:
At least 52.


Tanzania:
At least 10, mostly swimmers.


Seychelles:
Three.


Bangladesh:
Two.


Kenya:
One.

Seattle Times news services


Health officials believe many wells close to shorelines are likely to have been contaminated by rushing seawater, forcing the thirsty to drink from puddles and streams running past corpses and hastily dug toilet pits. The full effects of malaria- and dengue-carrying mosquitoes would not be known for weeks — the incubation time of those diseases. It takes more than a month for hepatitis to gestate.


“There is certainly a chance we could have as many dying from communicable diseases as from the tsunami,” said David Nabarro, a spokesman for the health organization.

The United States increased its aid contribution from $15 million to $35 million, but that’s only a start. About $4 million will go directly to the Red Cross relief effort.

More than two dozen other countries offered cash or assistance. The 25-nation European Union pledged $30 million, Japan $30 million, Saudi Arabia $10 million, Australia $8 million, Canada $4 million and China $2.6 million.

Israeli governmental and nongovernmental organizations dispatched hundreds of relief workers to disaster sites, and the Israel Defense Forces planned to send more than 140 search-and-rescue workers.

“We know the needs will be greater,” State Department spokesman Adam Ereli said. “This is a disaster of almost unimaginable dimension, and it’s going to require a massive support for some time.”

DAVID LONGSTREATH / AP

Volunteers place bodies in coffins yesterday in preparation for cremation, near Takuapa, Thailand. Bodies are still being recovered, and the country yesterday issued a call for more body bags.


Katoch, a veteran of about 80 international disasters, predicted that the long-term recovery effort would cost billions of dollars and take at least five years.

Organizations trying to deliver help faced a logistical nightmare. Clean water was the priority in almost every affected area, but some countries had special problems.

In Sri Lanka, the site of a long-running civil war, rushing water from the ocean scattered land mines and washed away warning signs on known minefields. Some parts of Indonesia, the hardest-hit country with almost half the reported deaths, still were inaccessible. Thailand issued an urgent call for more body bags.

Communications with many parts of the region were cut off. The Maldives, a nation of 300,000 people stretched over 200 islands in the south-central Indian Ocean, lost touch with 19 inhabited islands, raising fears that some could have been swallowed by the sea.

The initial response was a bit chaotic as relief organizations scrambled to assess needs and deploy resources. Jan Egeland, the United Nations’ emergency-relief coordinator, angered U.S. officials Monday by complaining that some unnamed rich countries had been “stingy” in their commitments to help.

Secretary of State Colin Powell responded yesterday with a vigorous defense of the United States. “The United States is not stingy,” he said. “I wish that comment hadn’t been made.”

The U.S. government pledged an additional $20 million, on top of $15 million offered earlier, and Powell said more would be coming.

MANISH SWARUP / AP

A mother cries as she feeds her daughter yesterday while waiting to be evacuated on an island off India. Relief groups yesterday were working to assess needs and deploy resources.


Although Egeland withdrew his earlier comment, domestic criticism of President Bush surfaced. Skeptics said the initial aid sums — as well as Bush’s decision at first to remain cloistered on his Crawford, Texas, ranch for the Christmas holiday rather than speak in person about the tragedy — showed scant appreciation for the magnitude of suffering.

After a day of inquiries about his public absence, Bush late yesterday announced plans to hold a National Security Council meeting by teleconference to discuss several issues, including the tsunami, followed by a short public statement. Bush also authorized military assistance, including the dispatch of two U.S. carrier task forces carrying thousands of Marines and their helicopters and landing craft from Hong Kong and Guam, and a dozen C-130 transport planes to deliver tents, water, clothing and other supplies.

Earlier yesterday, White House spokesman Trent Duffy said the president was confident he could monitor events without returning to Washington or making public statements in Crawford, where he spent part of the day clearing brush and bicycling.

Some foreign-policy specialists said Bush’s actions and words communicated a lack of urgency about an event that will loom as large in the collective memories of several countries as the Sept. 11 attacks do in the United States. “When that many human beings die — at the hands of terrorists or nature — you’ve got to show that this matters to you, that you care,” said Leslie Gelb, president emeritus of the Council on Foreign Relations.

There was an international outpouring of support after the attacks on the World Trade Center and Pentagon, and even some administration officials familiar with relief efforts said they were surprised that Bush had not appeared personally to comment on the tsunami tragedy. “It’s kind of freaky,” a senior career official said.

Compiled from Knight Ridder Newspapers, The Dallas Morning News, the Chicago Tribune, The Washington Post, The Associated Press and Reuters.