Tens of thousands of tsunami survivors are at risk from killer diseases, such as cholera, despite stepped up international aid, the World Health Organisation (WHO) said today.
WHO crisis chief Mr David Nabarro, asked whether an earlier warning that some 50,000 people could succumb to disease still stood, said: "It is still too early to make that judgement."
Nearly 130,000 people are known to have died when a massive earthquake off Indonesia's Sumatra island on Sunday sent walls of water crashing onto shorelines as far away as Somalia. But with five million people short of either water, food or basic sanitation across the Indian Ocean, a further toll of 50,000 from disease and other causes would be in line with that seen in earlier humanitarian emergencies, Mr Nabarro said.
"At the moment the international operation is incredibly strong...in getting relief to airports. But we still have to be sure we have got the necessary relief reaching people," he said.
There were reports of diarrhoea, which can be particularly dangerous to children, amongst those left homeless in India and Sri Lanka, while the situation in Indonesia's Aceh province was still unclear.
"We are not alarmed yet, because we expected this...It will be a few more days before we can be confident we have been able to avoid major disease outbreaks," Mr Nabarro told journalists.
The official was speaking after meeting Health Minister Mars Di Bartolomeo of Luxembourg, whose country holds the presidency of the European Union, to coordinate aid. The EU has pledged $202 million, which Mr Di Bartolomeo said was just a start.
The United Nations is due to launch its formal appeal for help for Indian Ocean countries, particularly Indonesia and Sri Lanka, next week, with a donors conference set for January 11th.
Aid and medicines were flowing into Sri Lanka and the UN health agency was "much happier" about the distribution network there than a couple of days ago, although there were still difficulties in reaching the north of the island, Mr Nabarro said.
But accessing Aceh, the Indonesian province that was home to some two-thirds of the dead, still posed huge problems, he said. "We have shipped in loads of medicines into Jakarta and there is a lot of medical gear on the way (to Aceh), but we still need warehouses and vehicles for distribution," he said.
The agency was also concerned about Somalia and Myanmar, despite the military government there saying that the southeast Asian country had escaped relatively unscathed.