Published: January 3, 2005

Helicopters from the American aircraft carrier Abraham Lincoln brough t supplies to Krueng Raya, 15 miles northeast of Banda Aceh, Indonesia.

ANDA ACEH, Indonesia, Jan. 3 - "One, two, three, lift," Wing Commander Bill Griggs of the Australian Air Force signaled to the young Indonesian medics today as they heaved a stretcher bearing Siti Hawa, 60, who has a fractured femur.

Gray-haired and frail, Ms. Hawa, 60, was one of the 41 victims of the tsunami plucked from the obliterated coastline of Aceh by a shuttle of helicopters from the American aircraft carrier Abraham Lincoln in the third full day of a medical operation centered at the airport here.



The international relief effort in Indonesia finally sprang into action here eight days after the tsunami hit this region and just before a major conference of donors in the Indonesian capital Jakarta. Secretary of State Colin L. Powell, the United Nations secretary general, Kofi Annan, and other leaders are scheduled to attend the two-day affair, sponsored by the Association of Southeast Asian Nations.

In an appeal last weekend for international assistance, the Indonesian president, Susilo Bambang Yudhoyono, said he welcomed help for survivors and for reconstruction as a show of "global unity." In some respects today, he seemed to have achieved his goal.

While the Americans provided much of the hardware at the airport, they did not dominate the proceedings, which seemed to have been choreographed - but were probably more ad hoc - into a mosaic of international goodwill.

Transport planes from Singapore rested on the tarmac here between flights after dropping off supplies from the United Nations World Food Program. Heavy-lifting Chinook helicopters from Singapore flew along the coast too.

The airport here, virtually idle two days ago, was a whirl of activity from early morning until sundown today, with the wounded being ferried from the American helicopters across the tarmac into a triage tent for examination, and then onto a truck to one of the two overcrowded hospitals in this battered city.

The operation involved American pilots and medics, an Australian coordinator, a team of doctors from China and Indonesian soldiers working side by side. At times international language - the thumbs up - sufficed for words as two Indonesians, an American and an Australian held the four corners of a stretcher with an injured boy and lifted it carefully from one of the helicopters.

In 30 sorties today down the coast to more than half a dozen towns, more than 60,000 pounds of water, medical supplies and food were delivered. More than a dozen medical personnel were dropped off and patients suffering from eight-day-old festering wounds were ferried to safety, American military officials said.

"We are seeing a lot of broken legs, a lot of lacerations, a lot of pneumonia from all the salt water - about three quarters of the patients have pneumonia, among other things," said Lt. Lisa Peterson, a doctor from the aircraft carrier.

As she spoke, a group of Chinese doctors in a nearby tent flying a flag with the insignia of the Medical Detachment of China International Search and Rescue Team knelt over an elderly man, who lay on a stretcher on the grass as they examined his scrawny torso slashed with lacerations.

He had been taken from his hut in Calang, one of the hardest-hit towns, just an hour earlier by Petty Officer Michael Ousley, an emergency medical technician on one of the Seahawk helicopters.

"I don't think he had had anything to eat for seven days," said Mr. Ousley as he rushed off to make another run down the coast.

Naturally, not everything went smoothly in the shoulder-to-shoulder effort.

A team of 40 emergency medical specialists from Spain's Agency for International Cooperation, who arrived early in the morning ready to start work within two hours, were still without an essential component tonight.

"There is a shortage of pure oxygen that we need for resuscitation," said Dr. Pablo Yuste, the leader of the team, as he tried to organize at the airport.

Nevertheless, he was confident that the Spanish field hospital would start operations Tuesday in the grounds of the main Banda Aceh hospital, which was swamped by the tsunami and then filled with fetid black mud. The hospital building was still too dirty for use and a temporary replacement would be set up under tents, he said. But he was not sure, despite the urgent needs, that organizers of the medical operation knew about the Spanish effort.

"We will send you some patients tomorrow," Wing Commander Griggs promised Dr. Yuste.

The commander was confident that more victims would be brought from the faraway villages by the helicopters. But among the Americans there was some question about whether it was really effective to bring wounded patients to the overcrowded hospitals here.

"The two hospitals in town can't cope," said Lt. Dave Edgarton.

At the Sakinah hospital, where Ms. Siti was sent, a team of Australian doctors and Indonesian doctors dispatched from Jakarta have replaced the local staff, who fled after the disaster.

The people arriving today from isolated areas had especially gruesome injuries, the doctors said. Because eight days had passed since they were first injured, the wounds had become grossly infected. Amputations were becoming increasingly necessary, and many victims were very sick from septicemia. Even many of the city dwellers who had not already received medical attention were in increasing difficulties.

"We had a woman today with just an inch-long wound on her thigh, but it was such a horrible infection we had to cut from her thigh to her ankle," said Dr. David Scott, an anesthetist from Australia. In another case, a young man had an infection in his foot that had spread to above the knee.

"He needed an above-the-knee amputation but he bled too much and died," Dr. Scott said.

As time passes, the likelihood of saving sick patients still stranded in remote areas was fading, said another Australian doctor, Alan Garner. Even some of those who arrive today would have a tough time surviving, he said.

"A 20-year-old guy brought in today said he was the sole survivor of his village," he said. "He was washed out to sea, walked for two days and was picked up by the American helicopter. But I suspect he's going to die, and he will be the last of his village."