World leaders pledged Thursday to work together to help tsunami-shattered regions recover from the worst natural disaster in living memory, saying it was a race against time to get aid to survivors before they succumb to disease.
U.N. Secretary General Kofi Annan urged nations to immediately come forward with the billions in aid they've promised, amid warnings that another 150,000 people may die from disease — more than doubling the confirmed toll of 140,000. Another U.N. official in Geneva, however, said the threat of waterborne disease was receding, thanks to relief efforts.
World leaders gathered for a day in Indonesia, hardest hit by the Dec. 26 disaster, to figure out the best way to speed aid to victims. While about $4 billion has been pledged worldwide, the United Nations has warned some of the promises might not be honored as in previous disasters.
Earlier Thursday, Secretary of State Colin Powell said tsunami relief efforts by the United States, India, Japan and Australia — a core group formed to coordinate their initial response — will now be merged into U.N.-led operations.
"The core group helped to catalyze the international response. Now having served its purpose, it will fold itself into the broader coordination efforts of the United Nations," Powell said in remarks presented at the summit.
As the conference ended, world leaders issued a declaration pledging to work together to help the shattered region recover and set up a tsunami warning system in the Indian Ocean to ensure that next time such a wave is generated coastal communities will have time to flee to higher ground.
"This unprecedented devastation needs unprecedented global response in assisting the national governments to cope with such disaster," the declaration said.
The relief and reconstruction could take up to a decade, the leaders said.
Annan urged nations to channel $1.7 billion of the funds to the United Nations for relief, including $977 million for emergency aid.
"Whole communities have disappeared," Annan said. "Millions in Asia, Africa, and even in far away countries, are suffering unimaginable trauma and psychological wounds that will take a long time to heal. Families have been torn apart.
"The disaster was so brutal, so quick, and so far-reaching, that we are still struggling to comprehend it," Annan added, stressing the need for donor "pledges to be converted into cash quickly ... It is a race against time."
The U.N. chief said the number killed across Asia and Africa would likely exceed 150,000, but the exact figure would never be known. Sri Lankan officials on Thursday recorded 375 more deaths, raising that country's total to 30,615.
The World Health Organization warned the toll across southern Asia could double if aid doesn't reach survivors soon.
"As many as 150,000 people are at extreme risk if a major disease outbreak in the affected areas occurs," said WHO Director-General Dr. Lee Jong-wook.
A tsunami warning system — like the one already in place in the Pacific — should be established in the Indian Ocean as quickly as possible, the leaders agreed. But they gave no specifics on funding or logistics for such a system, other than to say it should be the result of international cooperation and information sharing.
Japan planned to offer technical expertise to set up the warning system. The country has one of the world's most advanced networks of fiber-optic sensors, which can warn of deadly tsunami within two minutes of a quake.
"No longer must we leave ourselves so vulnerable and so exposed," Thai Foreign Minister Surakiart Sathirathaim said. "It is well-proven that 10 minutes advance warning can save hundreds of lives."
Countries around the world have pledged about $4 billion in addition to sending troops and teams of medics to the stricken regions. But there were fears much of the pledged money would not materialize.
Just over a year ago, donors promised Iran more than $1 billion in relief after an earthquake killed 26,000 people there. Iranian officials say only $17.5 million has been sent.
In a final paragraph to their declaration, the leaders vowed to work together to rebuild.
"We believe that through concerted efforts, spurred by spirit of compassion and sacrifice and endurance, together we will prevail in overcoming this catastrophe," the statement said.
As the delegates met in Jakarta, doctors warned of a looming catastrophe from ever-more serious health woes, including gangrenous wounds that require amputations, children with diarrhea and pneumonia caused by dirty water.
Indonesia was the worst affected by the earthquake and tsunami that ravaged 11 countries — including Sri Lanka, India and Thailand. The high ocean waves reached as far as eastern Africa.
The first patients turning up at hospitals and makeshift clinics in Indonesia's hard-hit Aceh province after the disaster had mostly scrapes, bruises and broken bones. Now, doctors say they are treating more serious problems.
In Aceh, dangerous infections were sneaking into superficial wounds, said Dr. Ronald Waldman, who is coordinating WHO efforts in Indonesia. Pneumonia has also emerged as a significant illness, caused by exposure to dirty water during the tsunami.
But the number of cases of children with severe diarrhea is still low, and the cases are not thought to be due to the germs that cause cholera or other illnesses that could explode into epidemics, he said.
"Five million people have been severely affected by the tsunamis," said WHO Director-General Dr. Lee Jong-wook. "We now estimate that as many as 150,000 people are at extreme risk if a major disease outbreak in the affected areas occurs."
A U.N. official in Geneva told The Associated Press, however, that the threat of waterborne diseases was diminishing, largely because of the medical aid flowing into the region.
An early U.N. focus on the threat of cholera, typhoid and dysentery has helped to prevent a major disease outbreak, even though the incidence of diarrhea has increased in many affected areas, said Jamie McGoldrick at the U.N. Office for the Coordination of Humanitarian Affairs.
Meanwhile, a powerful 6.2-magnitude aftershock centered close to the provincial capital Banda Aceh shook the city after dawn Thursday. Many residents panicked and fled into the streets fearing their homes might collapse, but there were no reports of fresh casualties.
As international aid poured into Muslim Indonesia, some radical Islamic groups were sending men into Aceh — perhaps to stir up sentiment against U.S. and Australian troops there, a terrorism expert said.
"They appear to see their role not only as helping victims but as guarding against 'kafir' — infidel — influence," said Sidney Jones, Southeast Asia project director for the International Crisis Group.
Dozens of trucks were rumbling out of the airport at Banda Aceh, loaded down with drinking water, instant noodles and other aid. American helicopters clattered overhead rushing food to devastated villages on Sumatra's west coast. Australian choppers were landing at the airport with scores of injured.