INDONESIA: As the pale grey SH-60F Seahawk helicopter touches down at Banda Aceh airport, three dozen sailors in navy blue overalls file out across the thick mud to form a line that in a matter of minutes loads a tonne of rice, water and high-protein biscuits.
Seconds after the chopper lifts off, another is in its place and the process begins again, to be repeated almost 100 times, from dawn to dusk, as it has been each day since January 1st.
The sailors, catapulted at daybreak off the aircraft carrier USS Abraham Lincoln in a cargo plane for the 20-minute flight to shore, have volunteered to spend the day hauling relief supplies for the victims of the south Asian tsunami.
At the end of a 12-hour day here, the medics, engineers, quartermasters, weapons specialists and crewmen and women will return to their full-time jobs aboard the aircraft carrier to catch up with the backlog.
Apart from a handful of Australian helicopter engineers who lend a hand during their free time, the Americans will work alone to shift around 100,000lb, or 42 tonnes, of food, water and medicine into the inaccessible heart of Aceh province.
Nearby, the Australians and the British have a couple of ageing Huey helicopters on the go, and the New Zealanders are ferrying in supplies aboard cargo planes. The Indonesian military has set up a squalid base camp, and smaller non-government organisations have established a tented city, as they have in Meulaboh, 200km to the south, to provide a range of medical services to tsunami victims.
Here on the American side of the airport, the Lincoln's half-dozen helicopters are flying more than 80 missions a day. Each mission makes a number of stops to deliver supplies, drop off, collect and move around doctors and other aid workers in outlying areas, and fly freelance searches for isolated communities that haven't yet been reached.
On the surface, it appears that the bulk of the aid effort is being borne by the American military. Two carrier groups afloat off the north Sumatran coast, including marines aboard the USS Bonhomme Richard, have suspended normal operations to concentrate on Aceh's needs.
The biggest stumbling block in that effort, according to sources close to the US Navy and some international NGOs, is a lack of central co-ordination that appears to be hampering the full utilisation of resources that have flooded into Aceh since the December 26th tsunami that has now claimed more than 160,000 lives in Indonesia alone.
Part of this can be attributed to the American military's reluctance to depart from standard procedure and engage the multi-national relief effort on any but its own terms. Part is due to a lack of understanding of local cultural mores, such as a general reluctance by Acehnese to seek hospital care. And part is due to a reluctance by relief organisations to work with foreign military, especially the Americans, for fear this could taint a perceived reputation for neutrality.
Dr Kwan Yong Jin, who led a delegation of the Korean Medical Association that spent nine days in Aceh and returned to Seoul yesterday, said the lack co-ordination had caused confusion and infighting among NGOs and led to a duplication of efforts.
"The many NGOs arriving in Banda Aceh must find places to set up their medical services by themselves, and there is a lot of competition between the NGOs and the UN in the process of finding places, which leads to a lot of fighting," Dr Kwan said through an interpreter.
"The other problem is cultural. We found that according to the medical culture of the Indonesians, hospitals are a luxury, and they don't want to go to hospital even though they are very sick.
"So we have concluded that the NGOs must go to the patients, not wait for the patients to come to them. But their ability to do so, even if they understood this need, is limited because of the lack of centralised co-ordination of their efforts. The providers (of help) are not being matched to those in need," Dr Kwan said.
Concern about the lack of co-ordination has reached the upper echelons of the US military, which has commissioned a report on how communications blockages can be cleared in order to smooth the flow of aid supplies.
A source close to the navy said action was needed within days, but doubted the willingness of the UN and other aid organsations to be fully engaged with the military. The information would probably be most useful, he said, "next time."
Mr William Bergman, public information officer at the UN's Office for the Co-ordination of Humanitarian Assistance in Jakarta, described the system so far as being "functionally successful".
"There is no big conceptual framework that includes the US military, no formal, regular working out of sectoral concerns that includes the United States' and all military components."
He did not see this as a hindrance, despite the speed with which a vast array of differing aid efforts arrived in Aceh, "because it's a hindrance to what?"
"As far as the major objectives of the international effort, to stabilise injuries, stave off starvation and disease, get food to almost everybody, it's happened.
"It could be more efficient, but everyone agrees that it's been OK." The priority now was to work towards a "demilitarisation" of the aid effort.
"We've gone beyond thinking there will be smooth communication between everybody to looking forward to a demilitarisation of the whole effort, so it will be the humanitarian actors themselves that work together," Mr Bergman said.
"I think it will be perfect by the time the military pulls out."