Donald Greenlees, Banda Aceh – The home that Epayani left behind at Meulaboh, on the west coast of Indonesia's Aceh province, now lies under the sea.

Her last memory of the concrete cottage in a military compound is of waves crashing against the roofline before she was thrown into the swirling water.

But the 31-year-old wife of a second sergeant in the Indonesian army is among the lucky. Her husband and three children survived. Her nine-year-old son was rescued after two days floating alone on a mattress without food or water. The family was one of the few in Meulaboh, 250 kilometers south of Banda Aceh on the Indonesian island of Sumatra, to escape the devastation wreaked by Sunday's earthquake and tsunami. Estimated to have had a population of 40,000, the town is now an open-air morgue.

Epayani, her eyes puffy from tears and a lack of sleep, said she had seen thousands of dead in her home town gathered in great piles by local government officials, police and soldiers. "There is no place to bury the bodies," she said Thursday after being airlifted by helicopter to Banda Aceh. "They don't know where they are going to put the bodies because there is so much water around."

As Indonesian and foreign relief teams slowly reach the isolated pockets of refugees along Aceh's western coastline, they are facing an overwhelming humanitarian crisis. The Indonesia head of the UN Office for the Coordination of Humanitarian Affairs Michael Elmquist said no part of Indonesia had been worse hit than the town of Meulaboh, which had taken "the full brunt" of the earthquake and tsunami. "From what people have seen from the air it looks like the town of Meulaboh is 90% destroyed. There might not be many survivors," he said.

For the living, the conditions are dire. Some fled into the mountains; others to camps set up around government offices and military bases. Survivors say there are shortages of almost all basic necessities: clean water, food and medical supplies.

Even before the misery brought on by last Sunday's tsunami, Aceh was one of Indonesia's most troubled provinces. Fertile and heavily forested, devoutly Muslim Aceh has clashed repeatedly with the central government in Jakarta since Indonesia's independence in 1945.

Separatist groups, protesting that Jakarta milked the province of timber, natural gas and other valuable resources while oppressing its residents, have waged sporadic armed rebellions dating back to the 1950s. Under former President Suharto, the Indonesian military effectively ruled the province for much of the 1990s with an iron fist. Human-rights groups blame the military for the killings, torture and disappearance of thousands of Acehnese during that period that left a legacy of deep bitterness and resentment toward Jakarta.

More recent attempts at reconciliation in the post-Suharto era have largely failed and the tense armed confrontation between rebels and Jakarta has continued to keep Aceh isolated from Indonesia's political mainstream and economically backward despite its natural wealth.

It's not clear what impact the quake disaster might have on the warring parties, who are adhering to a de facto ceasefire since the catastrophe struck. In a sign of official concern about the conditions in Meulaboh, Indonesian President Susilo Bambang Yudhoyono is expected to spend New Year's on a boat offshore and visit the town.

Some analysts say now may be a unique chance for reconciliation and opening of the province to the rest of Indonesia – provided Mr. Yudhoyono can engineer an effective rescue and rehabilitation plan. That would be a political triumph torn from tragedy. But many also fear that misadministration, corruption and lack of political will on Jakarta's part could drag the battered province back into the violence and political chaos it has suffered for almost 60 years.

The extent of Aceh's suffering is growing clearer as aerial surveys of the coast have forced government officials to sharply lift the Indonesian death toll. On Thursday, it was put at almost 80,000. It is certain to go higher.

In Banda Aceh alone, where five days after the disaster bloated corpses still lie in the open, there are an estimated 26,000 dead. Officials fear that the toll will be much heavier on the coast. "From Trumon to Greater Aceh along the coast, all is gone," said former Human Rights Minister Hasballah Saad, a respected Acehnese leader. "The character of the area is that the population was concentrated on the coast."

Survivors and local government officials who have trickled into Banda Aceh report as much as three-quarters of the populations of coastal settlements were killed. Asri Achmad, an irrigation official in the local government of Lhoong district, said only four of 28 villages in his district escaped total destruction. The local government had its own grim head count: of the 12,322 people who lived in the district, 9,230 died.

Traveling into Banda Aceh by helicopter – roads from the capital are impassible, broken by the force of the quake or littered with debris from the sudden catastrophic rise of the sea – he could see neighboring districts had suffered a similar fate. "The water has gone black in many areas," he said. "I assume this is because these ponds were full of bodies."

Amid the tragedy there were stories of survival. After the torrent of sea water hit Meulaboh, Epayani was at home with her husband and three young children. As the water quickly rose, they climbed into a tree and then onto the roof of their house.

A rapid succession of waves broke across the roof, throwing them into the turbulent waters. They were all separated, though miraculously they survived. Her son Wira Dwilesmana, nine years old, survived by clambering onto a mattress, where he remained, alone, for two days before he was beached.

The family was reunited on Tuesday at a military base at Meulaboh. But the struggle for survival is continuing in the camps. Little aid has arrived from outside. The over-stretched Indonesia air force has managed small aid drops to Meulaboh, but many communities have had to do without.

Epayani said the first supplies of food, water and medicine only came in Thursday. "The children were crying for three days, asking for food," she said of conditions in the camp. Supplies of food stuffs, water purification and sanitation equipment has started to build up at Banda Aceh airport, coming in on Australian, Singaporean and Malaysian heavy-lift aircraft and helicopters.

The lack of infrastructure at the airport has made unloading painfully slow. Moreover, it has not been easy to ensure distribution to isolated communities.

Indonesia's military Thursday reached agreement with the Australian Defence Force to allow a significant upgrade of terminal services at Banda Aceh. Australian personnel are expected to be deployed in the coming days, bringing equipment and helicopters to allow distribution of supplies to remote areas.