International donors have promised about $2 billion in disaster assistance to the countries hit by the ocean surges, caused by an earthquake off the coast of Indonesia. Various groups are trying to find their own niches in distributing this aid, which has yet to reach some of the victims, according to reports.

While the tsunami killed an estimated 145,000 people from Thailand to Somalia, hundreds of thousands more survived but with often serious injuries.

"For the past 48 hours, we have had people on the ground assessing the needs, determining the diagnoses and describing the specific medical supplies that are needed," Howe, a physician, said in a telephone interview.

He said no one had a good estimate of the numbers of injuries yet.

But many survivors have described having been smashed by debris or simply pummeled by the water itself.

"The crush injuries or blunt injuries can come from the force of water," said Howe. They are often similar to those seen in car accident victims, he said.

"The end result is crushed tissues and crushed bones," he said.

"The people that inhaled the water -- that led to impaired or damaged functioning of the lung and an inability to expand the lung as well as to contract the lung. In that case you have a perfect setting for infection."

Surgical equipment and antibiotics will both be needed, Howe said.

Thai health officials in hard-hit Phuket have asked for surgical gowns, gloves and masks, while Indonesia's health ministry has asked for antibiotics, Howe said.

"We are preparing an airlift to respond to both of these calls for help," he said.