The death toll in the Indian Ocean tsunami disaster soared above 125,000 yesterday as millions scrambled for food and clean water and rumours of new waves sent many fleeing inland in panic.
Aid agencies warned that many more, from Indonesia to Sri Lanka, could die in epidemics if shattered communications and transport hampered what may prove to be history's biggest relief operation.
Rescue workers pressed on into isolated villages devastated by a disaster that could yet eclipse a cyclone that struck Bangladesh in 1991, killing 138,000 people.
Italian Prime Minister Silvio Berlusconi called for an emergency meeting of the Group of Eight so that the rich nations' club could discuss aid and possible debt reduction after "the worst cataclysm of the modern era".
The death toll had shot up more than 50 per cent in a day with still no clear picture of conditions in some remote islands around India and Indonesia.
While villagers and fishermen suffered devastation, losses among foreign tourists, essential to local economies, mounted.
Prime Minister Goran Persson, his government under fire over its tardy response, said more than 1,000 Swedes may have died. Some 5,000 tourists, mostly Europeans, are still missing four days after walls of water devastated beach resorts.
The Indonesian Health Ministry said just under 80,000 people had died in the northern Aceh province that was close to the undersea quake, some 28,000 more than previously announced.
The airport of the main city, Banda Aceh, was busy with aid flights, but residents said little was getting through to them. Hungry crowds jostling for aid biscuits besieged people delivering them in the city. Some drivers dared not stop.
"Some cars come by and throw food like that. The fastest get the food, the strong one wins. The elderly and the injured don't get anything. We feel like dogs," said Usman, 43.
Residents of the city fled their homes when two aftershocks revived fresh memories of the worst earthquake in 40 years.
"I was sleeping, but fled outside in panic. If I am going to die, I will die here. Just let it be," said Kaspian, 26.
Rumours, unfounded, of another tsunami swept to the seaboard of Sri Lanka and India, highlighting the continued tension across the stricken region four days after the quake.
The Indian government issued a precautionary alert for all areas hit by Sunday's killer wave.
Police sirens blared on beaches in Tamil Nadu, one of the worst hit states in a country that has lost 13,000, as thousands streamed inland on foot or crammed any vehicle they could find. "Waves are coming, waves are coming," some shouted.
This time, however, the waves did not come.
There were similar scenes in Sri Lanka, where more than 27,000 have been killed. Thousands fled inland from the coast.
"This isn't just a situation of giving out food and water. Entire towns and villages need to be rebuilt from the ground up," said Rod Volway of CARE Canada, whose emergency team was one of the first into Aceh.
The World Bank offered $250 million in relief, bringing total international aid to nearly $500 million. Representatives of 18 UN agencies consulted and Secretary-General Kofi Annan held a video conference with members of a four-country coalition announced by US President George W. Bush on Wednesday.
David Nabarro, head of a World Health Organisation (WHO) crisis team, said as many as five million people were now unable to obtain the minimum they needed to live.
Many villages and resorts from Thailand to Indonesia are now mud-covered rubble, blanketed with the stench of corpses after the 9.0 magnitude quake.
In Indonesia, thousands of bodies rotting in the tropical heat were tumbled into mass graves. Health officials said polluted water posed a much greater threat than corpses.
Authorities warned of many deaths from dysentery, cholera and typhoid fever caused by contaminated food and water, and malaria and dengue fever carried by mosquitoes.
Indonesian aircraft dropped food to isolated areas in Aceh on northern Sumatra, an island the size of Florida.
In Sri Lanka's worst-hit area Ampara, residents ran things themselves, going round with loudhailers, asking people to donate pots and pans, buckets of fresh water and sarongs.
"Frustration will be growing in the days and the weeks ahead," said UN emergency relief coordinator Jan Egeland.
The United States said a pledge of $35 million was just a start, and sent an aircraft carrier group towards Sumatra and other ships including a helicopter carrier to the Bay of Bengal.
A New York Times editorial, however, denounced the US pledge as a "miserly drop in the bucket".
"This is in line with the pitiful amount of the United States' budget that we allocate for non-military foreign aid."
Financial costs, estimated at up to $14 billion, are tiny relative to the human suffering. By comparison, Hurricane Andrew killed 50 people in 1992 but, with much of the damage in the US, cost around $30 billion.
In the Thai resort turned graveyard of Khao Lak, the grim task of retrieving bodies was interrupted briefly when a tremor cleared the beach of people in a flash. In Thailand alone at least 2,230 foreigners are known to have been killed.
Dutch, German and Swiss forensic teams flew to Thailand to help identify now hard-to-recognise bodies by collecting dental evidence, DNA samples, fingerprints, photographs and X-rays. Switzerland said 850 Swiss tourists were unaccounted for.
Preserving bodies was an urgent need and Prime Minister Thaksin Shinawatra promised to provide refrigerated containers.