BANDA ACEH, Indonesia – Survivors fought over packs of noodles in the quake-devastated streets of Indonesia's (search) Banda Aceh, while military transport planes dropped hundreds of food packets on the devastated coastline of Sumatra island.
In Sri Lanka (search), reports of measles and diarrhea were beginning to reach health authorities, causing concern of an epidemic, said Thilak Ranaviraj, the government's top official handling relief efforts. Clean water was in short supply.
Governments worldwide have pledged more than US$250 million (euro183.5 million) to help victims of the disaster, which killed tens of thousands and left millions more homeless in almost 11 countries from Southeast Asia to Africa.
U.S. President George W. Bush (search) said the United States, India, Australia and Japan have formed an international coalition to coordinate worldwide relief and reconstruction efforts.
"We will prevail over this destruction," Bush said in Texas.
U.N. emergency relief coordinator Jan Egeland, however, said it could take days to reach survivors and that some areas had yet to be reached. The U.N. has launched its own appeal for US$130 million (euro95 million).
"It will take maybe 48 to 72 hours more to able to respond to the tens of thousands of people who would like to have assistance today, or yesterday," Egeland said. "I believe the frustration will be growing in the days and weeks ahead."
Millions of people worldwide began seeking ways to transform their sympathy into practical help: Housewives, tycoons, local charities and churches dug deep to make donations.
The disaster caused by Sunday's massive earthquake and subsequent tsunami were stretching relief groups to the limit.
Relief organizations used to dealing with one or two crises at a time now have a dozen or more disaster zones and a death toll approaching 80,000 and rising daily. If diseases such as cholera and dengue fever break out, they could kill as many more, World Health Organization officials have warned.
Egeland said one of the biggest challenges would be sheltering all those displaced by the disaster.
"These are ranging from the villages that were wiped out in Somalia on the horn of Africa — Somalia has been largely forgotten because we have only accessed really these areas over the last 48 hours — to all the people displaced in Sri Lanka to the growing number we are now aware of in Indonesia."
In Indonesia, the devastation centered on Aceh province on Sumatra Island, which Egeland said "had the greatest devastation." The official toll topped 45,000 dead and officials warned of tens of thousands more.
Supplies — including 175 tons (193 U.S. tons) of rice and at least 100 doctors — had reached the provincial capital of Banda Aceh by Wednesday. Four hospitals across Aceh were being set up and military cargo planes had begun making food drops across the island.
The navy also is sending ships with tons of food and medicine to the island's west coast, which is impossible to reach overland. It was due to arrive Thursday.
But aid officials admitted they are running into problems delivering aid to hard-hit regions, due to a shortage of gasoline and destroyed in many rural areas.
Survivors complained of running out of food in Banda Aceh and there were scenes of chaos with troops tossed out packets of noodles to refugees. Many others have been forced to seek shelter in government offices, mosques and schools, or were simply living in the streets.
"The aid is here but we are having trouble coordinating it," said Dr. Kace Keihulu, of Medicines Sans Frontiers, or Doctors Without Borders. "We need to know how we can help."
In India, the coastal highway in Tamil Nadu state was buzzing with convoys of aid trucks, loaded with clothing, food and tarpaulins. Large posters plastered on the trucks advertised the aid agencies and, in some cases, political parties joined the somber parade.
"Villages have become ghost villages with broken, empty houses and the stench of decomposed human bodies prompting the police where to look for victims," said UNICEF staffer Anupam Srivastava.
Thousands of families were living in camps being run by churches and aid groups.
In Thailand, an international airlift was underway to ferry critical aid and medical supplies to devastated resort island of Phuket and to take home shellshocked tourists who survived earthquake-powered killer waves.
Jets laden with supplies from France and Australia were among the first to touch down.
Almost all of the nations hit were poor and developing, and will be largely reliant on outside help to cope.