As the world scrambled to the rescue, survivors fought over packs of noodles in quake-stricken Indonesian streets Wednesday while relief supplies piled up at the airport for lack of cars, gas or passable roads to move them.
The official death toll across 12 countries soared to near 77,000 and the Red Cross predicted it could pass 100,000.
Bodies were piled into mass graves to ward off disease. Paramedics in southern India began vaccinating thousands of survivors against cholera (search), typhoid (search), hepatitis A (search) and dysentery (search), and authorities sprayed bleaching powder on beaches where bodies have been recovered. In Sri Lanka, reports of waterborne disease such as diarrhea caused fears of an epidemic.
President Bush announced the United States, India, Australia and Japan have formed an international coalition to coordinate relief and reconstruction of the 3,000 miles of Indian Ocean rim walloped by Sunday's earthquake and the tsunami it unleashed.
"We're facing a disaster of unprecedented proportion in nature," said Simon Missiri, a top Red Cross official. "We're talking about a staggering death toll."
On hundreds of Web sites, the messages were brief but poignant: "Missing: Christina Blomee in Khao Lak," or simply, "Where are you?" All conveyed the aching desperation of people the world over whose friends and family went off in search of holiday-season sun and sand and haven't been heard from for four days.
But even as hope for the missing dwindled, survivors continued to turn up Wednesday. In Sri Lanka, where more than 22,000 died, a lone fisherman named Sini Mohammed Sarfudeen was rescued by an air force helicopter crew after clinging to his wave-tossed boat for three days.
Indian air force planes evacuated thousands of survivors from the remote island of Car Nicobar. Some of them had walked for days from their destroyed villages to reach a devastated but functioning airfield, where they were shuttled out 80 to 90 at a time.
Journalists were not allowed to leave the base to verify reports that some 8,000 people were dead there, but at the base alone, 67 officers and their families were missing and feared dead.
India's death toll rose to nearly 7,000, while Indonesia's stood at 45,268, but authorities said this did not include a full count from Sumatra's west coast, where more than 10,000 deaths were suspected in one town alone.
In Sumatra, the Florida-sized Indonesian island close to the epicenter of the quake, the view from the air was of whole villages ripped apart, covered in mud and seawater. In one of the few signs of life, a handful of desperate people scavenged a beach for food. On the streets of Banda Aceh, the main town of Sumatra's Aceh province, the military managed to drop supplies from vehicles and fights broke out over packs of instant noodles.
Maj. Gen. Endang Suwarya, military commander of Aceh province, said after flying over the stricken region that 75 percent of the west coast of Sumatra was destroyed.
Footage shot by an Associated Press Television News cameraman on the military helicopter showed town after town covered in mud and sea water. Homes had their roofs ripped off or were flattened.
A solitary mosque and green treetops were all that broke the line of water in one town.
With tens of thousands of people still missing across the entire region, Peter Ress, Red Cross operations support chief, said the death toll could top 100,000. More than 500,000 were reported injured.
"We have little hope, except for individual miracles," Jean-Marc Espalioux, chairman of the Accor hotel group, said of the search for thousands of tourists and locals missing from beach resorts of southern Thailand — including 2,000 Scandinavians.
The State Department said 12 Americans died in the disaster — seven in Sri Lanka and five in Thailand. About 2,000 to 3,000 Americans were unaccounted for.
Bush, at his ranch in Crawford, Texas, talked by phone Wednesday with leaders of Indonesia, Sri Lanka, Thailand and India.
"We're still in the stage of immediate help. But slowly but surely, the size of the problem will become known, particularly when it comes to rebuilding infrastructure and community to help these affected parts of the world get back up on their feet," Bush said afterward.
The Pentagon says it will divert several U.S. warships and helicopters to the region, some of which can produce up to 90,000 gallons of drinking water a day.
Without clean water, respiratory and waterborne diseases could break out within days, putting millions at "grave risk," the U.N. children's agency said. "Standing water can be just as deadly as moving water," said UNICEF Executive Director Carol Bellamy. "The floods have contaminated the water systems, leaving people with little choice but to use unclean surface water."
Near Banda Aceh, trucks dumped more than 1,000 bloated, unidentified bodies into pits. There was no choice, given the danger of disease and the difficulty of identifying any of the dead, said military Col. Achmad Yani Basuki.
Thailand said it had more than 1,800 dead and a total of more than 300 were killed in Malaysia, Myanmar, Bangladesh, the Maldives, Somalia, Tanzania and Kenya.
In Sri Lanka, four planes arrived in the capital bringing a mobile hospital from Finland, a water purification plant from Germany, doctors and medicine from Japan and aid workers from Britain, the Red Cross said.
Supplies that included 175 tons of rice and 100 doctors reached Banda Aceh but officials said they were having difficulty moving it out.
Widespread looting was reported in Thailand's devastated resort islands of Phuket and Phi Phi, where European and Australian tourists left valuables behind in wrecked hotels when they fled — or were swept away.
An international airlift was under way to ferry critical aid and medicine to Phuket and to take home shellshocked travelers, some with nothing but the clothes they were wearing. France, Australia, Greece, Italy, Germany and Sweden were sending flights.
The world's biggest reinsurer, Germany's Munich Re, estimated the damage to buildings and foundations in the affected regions would be at least $13.6 billion.
Relief donations came in from all parts of the globe, from governments and from ordinary people who gave blood, money — even frequent flier miles — to help.
Taxi drivers in Singapore put donation cans in their cars. In Thailand, volunteers used trucks with loudspeakers to solicit donations of food and clothing, and there were long lines to donate blood at the Red Cross.
Hong Kong's kung fu movie hero Jackie Chan gave $64,000 to UNICEF, and Asia's richest man, Li Ka-shing, also of Hong Kong, gave $3.1 million to relief efforts.