Less than two months ago Wad Kowli was a river bank overgrown with tall grass known for miles around as a favorite watering hole for thousands of cattle. Today Wad Kowli is the Sudan's fastest growing city, a sprawling unplanned maze that faces a multitude of major problems, including lack of food, water and medicine as well as a danger of disease, flood and fire.

Since Dec. 10, when the first 10,000 refugees from Ethiopia's drought-stricken Tigray Province arrived on foot, more than 70,000 have followed, hoping to find food and medical care until the rains finally come in Ethiopia and they can go home. Many parts of Tigray Province have had drought conditions for three to four years.

A total of 127,000 refugees have arrived in Sudan from Ethiopia since October and relief workers have estimated that 600,000 may be here by the end of March.

Early last week there was talk among overworked relief officials -- representing the Sudanese government, the United Nations High Commissioner for Refugees and a scattering of private relief agencies -- that the numbers had finally stabilized. Arrivals had eased from as high as 3,000 a day to 600, then 20 and 84 on successive days. But on Jan. 24, a record 4,320 arrived. Some of them had been on the march for three weeks, some for much longer.

In the Sudanese capital of Khartoum, a Tigrayan official said, "We estimate 1,500 are starving to death every day among the 6 million to 7 million people" under the control of the Popular Front for the Liberation of Tigray and its allies in Ethiopia. The insurgents have been fighting the Ethiopian government for a decade.

Tekle Woin Assefu, in charge of the Relief Society for Tigray, an arm of the insurgent movement that is organizing the exodus of refugees, said: "If we had proper transportation, everyone would come out."

Osman Meki, the man on the spot for the Sudanese Commission of Refugees, and the western relief workers, don't like to think about those numbers. They keep revising their estimates, still hoping that Wad Kowli will not exceed 100,000 people.

The daily routine here begins after dark when the refugees, who have been fed by the relief society group at regular intervals along the line of march, walk the last eight miles in from the border, to avoid the 100-degree afternoon heat. Lined up in disciplined rows by village, with men in one line and women and children in another, the newcomers are counted.

The next morning they are registered, issued identity cards and deloused to prevent an outbreak of typhus. Their children are vaccinated and sent for special feeding.

Responsibility for distributing the food remains with the village elders to encourage cohesion and maintain the respect of a hierarchy that remains typically Ethiopian despite 10 years of revolution and upheaval.

As the refugees are organized, Wad Kowli is taking on many of the attributes of a medium-sized city -- albeit one without plumbing, electricity or other hallmarks of civilization. The French hospital, run by Doctors Without Frontiers, is about to start operating so the relief group's two doctors and four nurses will no longer have to dispense medicine under the trees.

The International Rescue Committee is organizing public sanitation and teaching 120 home visitors to instruct refugees about hygiene. Four more children's feeding stations are about to go up to join the original two. A giant Norwegian warehouse was erected in two days. There even are beds for important visitors.

The major concern is water. For if the first refugees chose this site because the Atbara River still had some running water, American specialists recently estimated that the now stagnant, isolated pools will be exhausted in four weeks to 10 weeks.

So acute is the water shortage that some relief workers are having second thoughts about the 10 recently installed U.S. Army inflatable water tanks each capable of holding 11,500 quarts and each equipped with a row of 10 faucets.

"Before the refugees had to fetch water from the river," a relief worker said. "Now they just turn on the spigot and waste a lot."

A team from Britain's Oxfam relief society was due to arrive this week to look for more water. No one here likes to think what will happen if none is found.

A lack of water in the next few months could turn into flooding if the Atbara fills up as it used to do before the drought here and in Ethiopia started three years ago. If that happened by June or July, the camp could be at least partially under water and awash in the accumulated waste from a field now set off as a giant outdoor latrine.

Even light rains will make many of the unpaved feeder roads to the main highway impassable because the now black soil turns quickly into mud a yard deep. That means that the camp must stockpile enough food to feed 100,000 people for at least four and perhaps five months until the road can be used again.

A rudimentary airstrip is being hacked out of the bush for emergency resupply, but flying in food is prohibitively expensive. A civil engineer is studying the possibility of paving the worst parts of the roads to allow all-weather travel.

Why keep the refugees here given all these problems? Part of the answer is that they spontaneously chose the site, which had the virtue of some shade trees and proximity to water.

But part of the answer is politics. For the refugees are on the side of the Atbara nearest to the Ethiopian border. And the Sudanese government, while willing to accept refugees, prefers to keep them as close to its frontiers as possible. That way they provoke a minimum of friction with the Sudanese and are less tempted to stay than if they were moved farther from the border.

So despite all the uncertainties, Meeki and the relief workers -- from the YMCA, Britain's Save the Children, the International Rescue Committee of the United States and France's Doctors Without Frontiers -- are proceeding as if Oxfam was sure to find the extra water.

Although Sudanese government policy is that the refugees should leave by May, plans have been made to keep the camp open for at least a year. The rains won't come in Tigray before late spring, those remaining in Tigray won't harvest the crops until November and only then could the long trek home begin. So day by day the relief workers are getting Wad Kowli more organized to cope with the flood of refugees. The food shortage -- which meant skipped and undersized rations for days on end -- was once critical, but has improved recently.

Even so, Julian Murray, the Briton who represents the U.N. High Commissioner for Refugees pleaded for more and faster food shipments. Plans are being made to break the encampment up into six decentralized sectors to lessen the chance of fire sweeping through the site and to increase the efficiency of aid to critically undernourished children, especially those under 5 who are the most at risk.

Many of the arriving refugees suffer from dysentery, malaria, bronchitis, pneumonia or just exhaustion, and there are fears of a meningitis epidemic. Yet all children under 5 have been vaccinated against measles and soon all those under 12 will be as well.

At first light the camp stirs. Camels parade down the camp's main drag carrying poles for huts to replace the emergency tents. Scavengers return from gathering fire wood. Bread is baked on open fires on flat pans. And the burial parties gather up the dead on rudimentary stretchers and take them to the cemetery.

When the death rate falls -- and it has doubled from a daily average of 10 in just a week -- then perhaps the refugees will stop singing their dirges in the middle of the night. And perhaps then some village elders will stop threatening to march their flock back home. Some have argued that the promised food is nowhere to be seen and that they would rather die at home.