Indonesian sailors load donations from people in Jakarta to tsunami-damaged Banda Aceh onto cargo ship Wednesday

The massive global aid operation to help the victims of Sunday's earthquake and tsunamis in the Indian Ocean is beginning to deliver results. The United Nations is warning that if emergency supplies do not reach those most in need soon, disease could double the disaster's death toll. Some 70,000 people are confirmed dead in 11 countries, and thousands more are still missing.

Around the rim of the Indian Ocean, emergency supplies food, medicine and water purification equipment are starting to arrive in quantity.

But the United Nations is warning that the emergency is far from over. David Nabarro of the World Health Organization says the outlook is grim if the assistance does not get distributed in time to prevent disease.

"There is certainly a chance that we could have as many dying from communicable diseases as from the tsunami," Mr. Nabarro.

International donors are stepping up to provide help. The United States has pledged an initial $35 million, and is sending two aircraft carriers to the region to help the effort. The European Union, Japan and Australia also made substantial contributions.

Some survivors are still beyond reach. In Indonesia, rescue teams are still struggling to get supplies to the stricken west coast of Sumatra Island, parts of which are less than 100 kilometers from the epicenter of the undersea quake.

The Indonesian navy has reached the town of Meulaboh, where government officials say as many as half of the 95,000 inhabitants might have died. Elsewhere on the coast many of the survivors will be spending another night without food, water or shelter.

Across the region, the confirmed death toll continues to rise, but equally distressing is the huge number that still remains unaccounted for. Many may never be found.

A massive international aid program the United Nations describes as the biggest ever is just getting under way.

But it will take time for the bulk of the assistance to arrive. And at the moment, in many of the 11 countries affected, most of the work is being done by the victims themselves and their desperately overstretched governments.

The Indian government has mobilized the army to set up refugee camps, where they are carrying out mass vaccinations against cholera, typhoid and hepatitis. Ramesh Chennithala, secretary-general of the ruling Congress Party, says more help is needed.

"Hundreds of people, young children, ladies they are all suffering in the camps. So the Indian humanity should come forward and give a helping hand to the people," he said.

Sri Lanka has mobilized not only the army, but the entire civil service.

Across the region, there has been a huge outpouring of support by ordinary people keen to provide food, water, shelter and financial assistance for the millions who have been left traumatized and destitute by Sunday morning's catastrophe.

But long-term aid is going to be vital: it will be years, if not decades, before life on the rim of the Indian Ocean returns to anything like normal.