BANDA ACEH, Indonesia, Jan. 5 - In the makeshift recovery room, Dr. Paul Shumack crouched on the floor cradling the head of Novi, 35, who had already lost her husband and only child to the tsunami, and now her right leg.
...
International health officials have warned of soaring numbers of casualties among survivors of the tsunami 10 days ago, but doctors here say that many of the most seriously injured died even before medical teams arrived here near the center of the devastation.
"To some extent a process of natural selection has occurred," Dr. Shumack said. "People with no treatment at all are already dead."
Those at gravest risk now are people like Mrs. Novi, who suffered relatively minor injuries and could have been more easily saved if she had received emergency medical care last week. There is little way to know precisely how many people like her are now dying, but doctors say time is running out.
After days of trying to save grossly infected limbs at the poorly supplied military hospital here, Dr. Shumack and others have increasingly resorted to amputation, in the hope of saving lives. The number of amputations suddenly climbed this week, he said.
http://nytimes.com/2005/01/06/international/worldspecial4/06wounded.html?hp&ex=1104987600&en=cb72defda19d9beb&ei=5094&partner=homepage