Paul Toohey – The stragglers below wave plastic flags and shirts as the US Navy Seahawk helicopter settles on an island of broken tarmac in the no-longer-existent village of Panga, some 100km south of Banda Aceh. It is the briefest of touchdowns.

Women and children rush towards the machine but air crewman Xipe Brooks wards them away from the blades with wild arm signals. Boxes of water and instant noodles are tossed out the side door. People touch their hearts in thanks.

The chopper pilot behind the mirror shades puts his hands together in the salaam "respect" prayer greeting, bowing his head. He pulls the machine up fast and they're gone, like rock stars. The Americans are winning hearts and minds in hell.

Others have been slower to roll into the disaster zone of Aceh, pussyfooting around perceived Indonesian sensibilities with aid bottlenecked in the Sumatran capital of Medan, a long way south of the afflicted areas. By Thursday last week, 11 days after the tsunami struck, four Australian Iroquois helicopters finally arrived in Banda Aceh, destroyed capital of Indonesia's most westerly province.

The Americans had meanwhile been for eight days staging constant all-day aid missions in 17 Seahawks to forsaken towns and villages on the west coast. Without them, the survivors would have starved to death. The Indonesian military has been of little help to these people. It appears stunned into organisational inertia, unable to cope, exposed as hopelessly unprepared for a humanitarian operation and shell-shocked after losing so many of their own.

The Australian military has in fact been here from early on, not that they've advertised it. Two teams of doctors and anaesthetists, all of them military reservists, flew in three days after the tsunami, but in order not to put out the notoriously touchy Indonesians, presented as civilian doctors so it didn't look like a military takeover. Such absurdities dispensed with, the Australian teams rapidly took over main surgery duties at two hospitals in Banda and began carving off legs and opening up limbs. No air-conditioning, no general anaesthetic. Pain relief under the blade comes from ketamine, a trauma drug that sends the patient into light unconsciousness but carries the side-effect of nasty hallucinations.

At the military hospital, a woman with gas gangrene – the infection so advanced that it is alive and spitting – is told she will need an amputation from just below her knee. She replies: "I don't want the choice." But there is no time to sit and talk her quietly through it. It's yes-or-no decision, right now.

She consents with a single sob and is wheeled onto the operating table, chest heaving with terror. Two metres from her, in the same theatre, reservist surgeon Peter Sharwood – a veteran of Rwanda, Bougainville, East Timor and others – is already snipping through the knee of an eight-year-old girl. Before the Australian team arrived, she'd had a mid-shin amputation which became infected. Now they have to go higher.

Anaesthetist Dr David Scott sends the older woman under and Perth-based Swiss military surgeon Dr Rene Zellweger is a short time later tearing at the leg with a saw-toothed garrotte, in sharp upwards jolts. The leg is dropped in a bin and she's wheeled away. Next.

A woman with a wound that was originally the size of a 10" coin is having her leg splayed open from ankle to crotch as Zellweger searches with a gloved hand among infection and dead tissue. Someone mutters something about the "rivers of pus". Zellweger had hoped to cut out the dead tissue and save the leg but found himself able to run his hand straight up the woman's thigh on a decaying yellow flesh trail all the way through to her hollowed-out buttock.

There's no muscle left, just infection. Amputation is out of the question because she'd have to be cut in half. The unstitched leg is bandaged together and she is sent to a ward with antibiotics. She cries, "Allah, Allah" in an eye-rolling ketamine nightmare. She will die.

"We shouldn't even be operating on some of them," says Scott. "They're too sick. This is a last-ditch effort." Team leader Dr Paul Schumack, who has treated conflict-zone patients the world over, says the wounds of war are cleaner.

This is different. People have been lying around in wards becoming steadily more infected as the team battles to get through the workload. The stench is unbearable. Re-amputations are common as infection climbs up limbs towards torsos.

Schumack says it has all been overwhelming. He allowed himself a tear the day before "for the first time in years. It was a woman, just another woman. Nothing particularly special about her case. We were just too little, too late. There isn't enough blood."

The eight-year-old girl is sent home with her parents only two hours after undergoing amputation. Dr Paul Luckin explains that she will get better care at home than what can be given here – and there's less chance of infection than in these festering wards.

Most of those who've been treated no longer have homes, so they are sent out of the Banda contagion zone south to Medan. US Secretary of State Colin Powell flew in to Banda airport last week and was taken to a tent full of amputees awaiting evacuation. It was his first meet-the-victims moment and as they lay on stretchers looking up at this sympathetic stranger, they didn't realise their evacuation had been delayed for hours because the airport had been closed to provide security for Powell. Even here, the stricken wait for politics.

Peacetime isn't supposed to look like this. Nor are the people, who are holding up well. Many Acehnese have the physical appearance of having been through a rusty barbed-wire washing machine. They are scraped, nicked, scarred, broke and homeless. Yet no one fights at food and water queues; they are orderly and tolerant. "We've had not one word of complaint from anyone about anything at all," says Sydney-based emergency nurse Lisa Dillon. "I work at Westmead Hospital and you hear nothing but complaints. I can't imagine Australians coping in the same way."

Not once, in many conversations with people who have lost family members, was there a tear. They seem to almost shrug at it, not callous but perplexed.

Trying to comprehend the scale of damage and loss in Aceh, which of all regions saw the worst of the tsunami, is quite possibly beyond the scope of a single human. The entire north-western coast of the island has, over hundreds of kilometres, been gathered up and hurled two or three kilometres inland.

It was the low-lying seaside areas of greater Banda Aceh city that took the greatest hit. Here, between 40,000 and 80,000 people were hunted out and thrashed lifeless by the great dirty wall of water. Hauling bodies from under the rubble has just begun.

The hideous task of corpse recovery has fallen to trudging teams of TNI – Indonesian army – and police, who pick through the foul, waterlogged acreage, often wearing only gardening gloves and paper masks. There is nothing sentimental to this work. Bodies are grabbed and tossed onto black plastic sheets, wrapped and hurled onto the back of trucks with the rest of the day's takings. It's as much dignity as the dead are going to get. Then it's off to the stinking mass grave along the airport road, where the local dingo-like dogs have begun to gather.

Stare into the rubble long enough and twisted human figures – at the same time purple, yellow and black – begin to take focus. They are almost invariably naked, clothes having ripped or rotted off. Bodies are everywhere and located by scent. No road-kill ever smelled like this. It is too acerbic, too sour and, at first, so unfamiliar that it is – strangely – instantly recognisable as human. When arriving in Banda for the first time there is an urgent compulsion to see the dead where they lie rotting. You have to do it to ground yourself.

At the village of Leupung, some 30km south, no help has yet come. That's because none is really needed. The locals say the entire event was over in five minutes, after which only 500 of the 8000 who lived here remained. Most were washed up in a valley where they remain, unburied. The flats closer to the sea are an open-air morgue. These bodies are in no state to be clutched or held close by loved ones. No one knows who they are anyway, except to say they were friends, neighbours and possibly family. They are distended and distorted beyond recognition.

The handful who remain in Leupung have already walked in to Banda or reported in to neighbouring villages but have quickly returned home to exist as scavenging post-apocalypse badlanders. One young man, pointing to the wreckage around him, explains why he has come back to nothing: "Mama somewhere here."

In a kampong – or village – in west Banda, where five miserable elephants hunt among ruins for corpses, a well-to-do man considers the loss of his wife and two daughters. He has not found them and now he never will. "It all depends on God," says Darma Ibrahim. "If God takes all my family, it's OK – no problem." He may sound indifferent but he is only mechanically reciting his lines. In this, the most devoutly Muslim – as distinct from hardline militant – of all Indonesia's provinces, God's will must be considered. Inshallah.

A group of young men explain that the tsunami was a result of the Acehnese showing insufficient gratitude to God. They are not angry at Him – they are angry at themselves, vowing to try harder to do His bidding in the future.

Many mosques remain standing, widely read as a sign of God's selective power. The engineering reality is that mosques have few walls, just pillars, and the water was able to flow straight through them.

Banda Aceh was no hick outpost. There were once 350,000 people here, a small but wealthy and stately city which has managed to repel the otherwise pervading Indonesian love of tinsel commercialism. Taxis are not covered in stickers and do not blare rock music; there's never been liquor to be had, except in the two or three hotels which are now fractured and uninhabitable; and the stereotypical long-haired Indo dudes talking drugs and chicks and rock'n'roll never had a place here. It was – and will be again – a sedate city led by Muslim intellectuals who have for centuries regarded themselves as an independent and pious people.

Aceh province has been closed to the world for two years due to a severe martial law clampdown. The Free Aceh Movement (Gerakan Aceh Merdeka or GAM) is, according to Jakarta, a failing ragtag guerilla movement. Whether it is or not, it is clear that anti-Java sentiment is widespread among the people. Many in Banda have not seen Caucasians for years and take the opportunity to tell of their struggle.

GAM and the army never fought pitched battles in the main streets of Aceh's towns and cities; there have just been countless skirmishes here and there.

But after losing East Timor, Java has made an example of Aceh to the rest of Indonesia: they will not allow the republic to disintegrate further.

The army knows it is despised and this tragedy will not bring Aceh and Java back together. Soldiers and police are massing in their thousands, under orders to carry their machine-guns at all times. Indeed, they never lay down their guns even when carrying bodies from the swampy flats – work that no one will thank them for in a hurry.

Indonesian television spares its viewers nothing, closing in on the mutant faces of the dead, whether child or adult. We might call it disgusting.

They call it death. People gather blankly around freshly discovered batches of corpses, hands over noses, expressionless. It is monsoon season, meaning the fields of death are only going to become more muddy and prone to disease incubation.

Morning and night, substantial tremors continue to rock the city, causing people to run to open spaces. The feeling is that the Aceh shakedown isn't over yet.