BANDA ACEH, Indonesia, Jan. 2 -- By the time the first truckload of clean water solution reached the refugee camp in Desa Rueng Bakjok village on Sunday, about 50 of the 1,000 people living here on muddy ground under plastic tarps were suffering from dehydration and diarrhea.
Still, the arrival of this first shipment of water treatment solution from CARE, the international aid organization, amounted to a triumph, given the obstacles hindering the flow of aid through this vast country in the wake of the catastrophic Dec. 26 tsunami.
Follow the path of a shipment of bottles of water treatment solution.
In these early days of a $2 billion multinational relief effort aimed at preventing the spread of disease in ravaged coastal areas, aid groups have been hastily assembling distribution networks, often from scratch. They must depend upon hard cash to secure airplanes, trucks and helicopters to get supplies from warehouses to communities in need.
The story of how a single load of water purification kits made its way from a Jakarta factory to the northern tip of Indonesia's Sumatra island -- the worst-hit area in the region -- highlights the difficulties confronting those supplying food, water and medicine and those hoping that that relief is really on the way.
Yet the story only hints at the magnitude of the disaster. In Indonesia's Aceh province, some 800,000 people are now believed to be living without clean water, according to aid workers. Perhaps two-thirds live in areas accessible by road, but the rest are marooned in wastelands where bridges and roads have been washed away. Reaching these communities will be considerably more difficult. CARE officials are now hoping for assistance from the U.S. Navy, whose helicopters, stationed on an aircraft carrier off Sumatra, could ferry water kits to them.
CARE's clean water mission began almost as soon as the earthquake that triggered the tsunami struck, just off the Sumatran coast. The leader of the organization's health programs in Indonesia, Endang -- who like many Indonesians goes by a single name -- was at that moment performing surgery in the city of Bandung on Indonesia's main island of Java. During a break, she heard about the earthquake on CNN.
Born in Bali and reared mostly on Java, Endang had years of experience tending to the victims of natural disasters. She had served with World Vision, an aid group, after the 2001 earthquake in India's Gujarat province and participated in relief efforts in the Philippines and the Solomon Islands.
Early reports on Dec. 26 showed Indonesia only slightly affected, with most of the casualties in Sri Lanka and India. But Endang kept looking at the map and thinking how close the quake was to Sumatra.
"I thought, 'It must be a mistake. The mortality is going to increase,' " she said.
Though she usually has been called on to tend injured disaster victims as a surgeon, Endang is also inclined to think about what happens in the days afterward, when dead bodies can pollute water and spread disease.
CARE had already launched a pilot program in the Indonesian province of West Timor, supplying water treatment kits developed by the U.S. Centers for Disease Control. With cooperation from the U.S. Agency for International Development, CARE had found a pair of factories in Jakarta to produce a highly effective chlorinated solution that could be added to jerrycans of water. A small bottle of this solution cost about 12 cents to produce and could treat roughly 100 gallons of water.
CARE had stocked up about 50,000 of these bottles in West Timor, and Endang tried to get this cache transported across the archipelago to Aceh. But it was a holiday weekend, and all commercial flights were booked. A charter was prohibitively expensive. So she turned to the two Jakarta factories that make the solution, placing an order for 100,000 new bottles.
By Tuesday, perhaps 20,000 bottles were ready, Endang said, but they were sitting in a warehouse in Jakarta, more than 1,000 miles from where they were needed. The United States had yet to fly an aid sortie from its newly established hub in Thailand, so its planes were not an option. And Indonesia's planes were tied up with the rescue operation.
On Wednesday, a team of 12 CARE staff members flew 5,000 bottles on a commercial flight to Banda Aceh, the capital of Aceh province. The rest were flown in Sunday by an Australian C-130 Hercules plane.
On Sunday morning, Endang stood nervously on a patch of grass at the newly assembled headquarters of the International Organization for Migration, a group specializing in refugee aid, which was responsible for the jerrycans. She had hired a private truck to distribute this first shipment, but the vehicle was already an hour late. She stood in the tropical sun, aiming her satellite phone skyward, vainly dialing the driver again and again.
"It's very frustrating," she said. "I have the treatment solution. I have the staff to distribute it. I just don't have the transport."
An American volunteer, Sarah Smith, suggested they give up on this driver and find another. But most trucks were still being used to take bodies to burial sites and haul away the ruins of buildings. Endang figured she had to preserve the relationship with the driver, who was the sole conduit between her chlorine solution and people who might otherwise drink lethal microbes.
"Maybe after the government cleans all this up, they will give us more trucks," she said.
At 12:30 pm -- about two hours late -- the driver finally arrived; he had been confused about the schedule and the pickup point. CARE staff members loaded the truck and drove off through streets lined with the gruesome aftermath of the disaster.
The CARE crew planned to distribute about 3,000 kits at 14 different camps, most set up at mosques in this devoutly Muslim region. The first stop was a mosque sheltering 1,050 people, who were taking their water from a nearby well.
"We don't have enough water, and many people are sick," said Nurhadi, whose sister and nine children were killed in the furious waves.
Endang stood at the center of a large and interested group, demonstrating how a few drops of solution in a plastic container full of water could work hygienic magic. Then she handed the boxes of the precious bottles to the camp leader for distribution.
At the next stop, a 75-year-old man with a silver beard and a cane greeted the CARE workers with a plea. "We want to drink," said Ilham, who lost two children and five grandchildren in the disaster. "We have been here three nights. We have nothing."
At one camp, people were digging into plates of steamed rice and vegetables. At another, people complained that the well water was oily and sickness was spreading. "This is the first day we've received anything," said Nurdin, 55.
The scenes appeared to be taking a toll on the CARE workers, their contribution seemingly dwarfed by the reality around them.
Outside the city, amid lush rice paddies, 1,000 people sat under plastic tarps in the heat of the day, one-fifth of them children under 9 who had lost a parent in the tsunami. The camp coordinator complained that there was not enough food, water or medicine. A quarter-mile away, roaring jets landed at the airstrip, presumably bringing in loads of aid. Why it wasn't getting here was a mystery.
"This place. They need medicine and food, and we just bring water," said Andy Manuhutu, a CARE volunteer.