Edward Cody, Bung Bak Yok – Rukaiyah's right arm has swollen dangerously, pus leaking from an angry gash along the inside of her elbow. The skin has yellowed on a forearm puffy all the way to the wrist.
Unchecked infection has led to the threat – and maybe the onset – of gangrene.
But Rukaiyah, 28, has not seen a doctor since a torrent of water destroyed her home a week ago in Banda Aceh, the capital of Indonesia's Aceh province, and swept her along for hundreds of yards in an uncontrollable surge marked by multiple collisions with churning debris. The mosque where she has found refuge along with 1,000 other tsunami victims has not been visited by medical personnel, refugees said. It has run short of tarpaulins to shelter from the rain, short of rice to eat, and short of pots and stoves to cook it in.
And yet Bung Bak Yok, this little village where Manassa Mosque has responded to last week's disaster as best it can, lies only three miles east of Banda Aceh's Sultan Iskandar Muda Airport, where planeload after planeload of relief supplies and emergency medical teams have begun pouring in. A week into one of the most devastating disasters in South Asia's history, an international campaign to help Indonesia recover has at last moved into gear, with the C-130 Hercules transport aircraft delivering food, medicine and tents. But from the airport on, the distribution system slapped together by still reeling local officials and visiting international aid groups has proved spotty at best. In camp after camp, village after village, people like Rukaiyah have yet to receive all the help they need.
"The distribution system is not working," said Nassir Khan Abdurrahman, a Malaysian Red Crescent volunteer who has logged more than 30 years' experience responding to natural disasters in Asia. "They know where to send it, but they have their friends, they have their families."
For Abdurrahman, two main factors slowed operations.
The first was a lack of trucks. The second was the Indonesian military, which has taken charge of the airport warehouse, where goods are received from relief flights and stored until they can be distributed around Banda Aceh and other damaged towns.
With its control of outgoing supplies, the military has played the major role in determining where scarce trucks head with their precious cargoes.
Disturbed by the way things were going, Abdurrahman said, he helped organize a protest Saturday by leaders of non-governmental aid groups to demand a change in the procedure. As a result, coordination of the aid flow out of the warehouse shifted – at least in principle – to a civilian logistics specialist from an Indonesian aid organization.
Aid officials from other countries, speaking on condition of anonymity because they were reluctant to be seen as criticizing the Indonesian military, also complained of the army's central role in distributing aid over the last week. For political reasons as well, they expressed eagerness to deal with Indonesia's civilian government rather than its military officers. The issue is particularly sensitive in Aceh province, where Indonesian troops have been fighting a separatist rebel movement with tough, sometimes brutal tactics.
At the same time, there is little civilian government to work with in some areas. The tsunami struck with such force across the northern tip of the Indonesian island of Sumatra, where Aceh province is located, that the civilian administrations of the province and Banda Aceh city were incapacitated. Many officials were killed in the unfurling waves. Many others lost their families, their homes and their health. As a result, the military has proved to be the only organization capable of responding swiftly with men and vehicles.
The Indonesian government's senior disaster response coordinator, Alwi Shihab, announced Sunday that he had appointed Maj. Gen. Ambang Dharmono to take command of immediate relief efforts, including aid distribution as well as the collection and burial of the bodies still strewn about some streets in Banda Aceh. Acting Governor Azwar Abubakar, who had been struggling to set up relief operations with a civilian staff decimated by the tsunami, was asked to concentrate on resuming utilities and public services.
Shihab, who is coordinating minister for welfare activities in Jakarta, the Indonesian capital, dismissed widespread reports that aid distribution was falling short. He denied that families faced hunger in towns and villages that were leveled along the coast south of here, where the tsunami destroyed bridges and left communities cut off from Banda Aceh.
Visiting two of the towns by helicopter Sunday, Shihab said, he saw "no signs of starvation or frustration with the logistics." During his stop in one town, he said that in addition to the helicopter that brought him in, he saw a US Navy helicopter and an Indonesian police helicopter delivering food.
"I can guarantee you there is no starvation, except for me, because I didn't have lunch today," he said at a news conference in Banda Aceh.
Said Sahar, a driver who brought his wife and five children here last Sunday immediately after their home in Banda Aceh was washed away, said most of the tarps, noodles and medicines available at the camp were provided by neighbors of the mosque and a group from the Kompas newspaper.
The refugees pooled their money and bought some food for themselves in suburban markets. He and other refugees got their blankets by driving a vehicle to the airport and persuading a soldier to hand some over. "The government doesn't care," complained Sahar, 48.
The camp here needs medical help to care for Rukaiyah's swollen arm, Sahar said, but also for Samsul Bahry, 35, a pedicab worker who has had trouble breathing since ingesting large quantities of water as
the waves carried him away. Doctors have pinpointed respiratory diseases caused by the ingestion of contaminated water, and gangrene caused by infected puncture wounds, as major causes of death in the days following the tsunami.
Another three miles east of the airport, about 4,000 refugees have gathered on the grounds of a mosque in Lanrabo village. No doctor has visited, even though several refugees suffer from infected cuts received while being tumbled around by the tsunami. Two of those infected died Saturday, according to Russeidi Ibrahim, 42, a physics teacher and refugee who has emerged as leader of the camp. Ibrahim said their limbs swelled badly before they died.
A government distribution truck brought rice to the mosque for the refugees, Ibrahim said. In addition, a local television station sent supplies, including dry biscuits. But more rice is needed, along with medicines, blankets and tents to provide shelter from off-and-on rains that mark the season.
Ibrahim said the camp sent a delegation to Banda Aceh to seek more food and, after filling out a form, received authorization to get 10 items on its list of needs. But when members of the delegation went to the airport to pick up the supplies, they got only three: instant noodles, rice and powdered milk.
Those in need of relief supplies – whether refugees themselves or aid organizations seeking to help them – have been ordered to report to the governor's headquarters in Banda Aceh to lodge their requests.
There, clerks have been assigned to help them fill out a form, after checking on the number of people to be helped and getting a stamped letter of authentication from the local community leader.
Armed with a signed authorization from the chief clerk, aid groups or refugee delegations are directed to the airport if their camp or community lies outside the city limits and to a downtown municipal services office if the refugees are inside Banda Aceh. But the downtown office ran out of food and shelter supplies within two days, its director said, and has since responded only to requests for medicine.
The director, Syahrullah, said he rented a truck with money donated by his staff and himself and went to the airport to seek more supplies. But the military logistics officers in charge at the airport warehouse declined to release the supplies, citing inadequate documentation. Told later of the problem, Syahrullah recalled, a provincial official helping to organize the relief system broke down in tears.