Indonesia: Lynne O'Donnell reports from on board the USS Abraham Lincoln, which has supplied 1 million lb of food, water and medical supplies to Aceh.
The threat of hunger, dehydration and disease is hanging over Aceh. Relief efforts are failing to reach the most vulnerable victims of the tsunami, and the impending departure of foreign troops helping in a humanitarian role, ordered by the Indonesian government, is likely to exacerbate the misery.
But the second-in-command of the US aircraft carrier at the fore of the international aid coalition in Indonesia's Aceh province said yesterday his mission had been extended and he had no plans to cease aid activities. "I'm not aware that we have been told we have to leave," Capt D.A. Lausman, executive officer of the USS Abraham Lincoln, said. "We don't have a date to leave, we will stay until we are not required any more. We are here to help," he said in an interview.
He added: "Our deployment has been extended from February and is now open-ended. It will be determined later how long we stay, so our job is to continue to fly every day."
Indonesia earlier this week imposed a time limit on overseas troops providing help for the hundreds of thousands of people in Aceh in need of relief, ordering that they leave by the end of March.
Official figures have put the number of dead in Indonesia at over 110,000, with the number of homeless or displaced people at 500,000.
Jakarta's demand drew a sharp response from Washington, where the administration reportedly said it would seek clarification; and from the UN, with Undersecretary for Humanitarian Affairs and Emergency Relief Co-ordination Jan Egeland saying: "The most important thing is to save lives and not have deadlines."
Personnel on board the Abraham Lincoln, which has been stationed off the coast of Sumatra island providing back-up for aid organisations working in Aceh's capital, Banda Aceh, since New Year's Day, said the situation on the ground was unlikely to improve soon.
Indeed, many directly involved in providing food, water and medical assistance described the situation as worsening dramatically for children and the elderly, the sick and the injured.
Helicopter pilots and the medical professionals flying into Aceh daily said they had witnessed a deterioration in the health and circumstances of many remote communities. One medic described the emerging situation as "the survival of the fittest".
They said that in areas where there was no army presence, or no village elders to keep the peace, violence and anarchy were the norm, with fitter people grabbing food and water from children and women, and the elderly not even attempting to get a share.
"Some people will hoard, they won't share, they'll take care of themselves only. That's human nature," said Navy medic Sylvia Esthay. "Older people, especially those who are hurt, can't get out to the helicopters. Younger people can, and you see them grabbing supplies."
Corpsman Michael Smith, who flew a mission yesterday, said signs of malnutrition and dehydration were becoming more obvious in outlying communities, including places where helicopters could not touch down. Children "are lethargic. They should be playing football, but they had no energy".
Crews were still finding communities that had not yet received any help, said Petty Officer Joseph Sabia. "It was like the first day all over again," he said, describing the desperation of people spotted on Thursday surviving on an islet in the midst of a filthy swamp where his helicopter could not land.
Lieut Commander John Schultz, a pilot, said the infrastructure devastation was so profound it would be a long time before supplies could be transported outside the cities by road. "A lot of bridges are gone, and the roads have huge chunks, a mile or more, that are just gone. Till the bridges are repaired and the coast road is passable, the only way to get help in there is by air."
Nor are people generally likely to be healthy enough to work on rebuilding, with many needing long-term care and recuperation.
Medics said even small wounds sustained three weeks ago were festering in the tropical heat into bone-baring, gangrenous messes. Mr Smith described a small girl who needed her foot amputated after a cut on her ankle became infected.
"The doctors noticed the infection had spread to her knee, so they were going to amputate there," he said. "Then as they explored more, they saw the infection was up to her groin, so the whole leg had to come off. But the next day, as they were preparing to operate, they found she had pneumonia, so she was going to die anyway."
Rain is creating stagnant breeding grounds for mosquitoes, adding malaria to already-severe health concerns that include tetanus, cholera, typhoid and dysentery.
The USS Abraham Lincoln was deployed from Hong Kong on December 28th, arriving in Sumatran waters on New Year's Eve and beginning missions the following day. So far, Capt Lausman said, it has transported more than 1 million lb of food, water and medical supplies to Aceh.