Since April 20, when army troops broke through an earthen barrier the Tamil Tiger rebels had erected around Sri Lanka's conflict zone, unleashing an exodus of tens of thousands of civilians, chaos has ensued.

As the dust settles, and restrictions are eased on access to some areas in the north where those who escaped have gathered, aid agencies face a daunting task. With the estimated number of displaced people now at 190,000, the logistics of handling so many people threaten to overwhelm the authorities.

There have already been reports of disturbances close to riots in some camps over food and water, with those in charge unable to cope.

Muslim Aid has had mixed success in terms of getting access. We put an application in to the defence ministry days ago for clearance for our water purification equipment and team, but have yet to hear back. It seems to be frightfully slow.

We can't complain though, since we've been told that ministry staff and even employees of the government's Disaster Management Centre (who are mainly retired army officers) have themselves been refused access if they don't have proper clearance.

Nonetheless, the team handling our mobile hospital - whose application was put in a few days later - managed to get permission and go in. They are currently posted in one of the main welfare camps in Vavuniya, where about 52,000 displaced people are living.

The situation is desperate and the authorities are clearly hard pressed to meet even the basic needs. There's a lack of food and water, and no proper sanitation facilities. Forget clothes or toys for the children.

DEATHS IN CAMPS

Over the last week, at least 20 people have died due to starvation and lack of medication. On April 29, when our team arrived at the camp, residents had received their lunch at 4pm and their dinner at midnight.

What's making matters worse is that there are no morgue or transport facilities, and while the authorities wait for Red Cross help, dead bodies are lying under trees.

The general in charge of the camp seems at his wits' end. "I wish there was something more that could be done, but there is no personnel or supply. I am not sure how long this can be sustained," he confides. But there don't seem to be any alternatives in the pipeline.

With the security situation still quite tight, and clearance needed to enter camps, it's obvious help will be slow. Our team had to wait two hours in a convoy just to enter the camp area.

There's growing concern about lack of access to water, as Vavuniya - a naturally water-scarce area - is facing growing shortages as a result of the surrounding jungles being cut down to house the displaced people.

Our camp itself is on a site that's been newly cleared of jungle and hence there's a threat of insects, reptiles and heat. We managed to get our hospital up on April 30, and so far we've seen about 1,500 patients each day, with many more queuing for treatment.

FRIGHTENED AND BEWILDERED

The ambulances provided by local partners have been busy ferrying patients to the three main hospitals surrounding Vavuniya. These are now overflowing, and just do not have enough space.

The four doctors assigned from the Ministry of Health have been on their feet the whole day. It's amazing to see their energy and dedication in the face of the huge challenge of treating the patients.

But they can only do so much as medical supplies seem to be running out. We estimate it will take about 1 million rupees (roughly $10,000) a day to provide the medicines needed.

Add to this the basic provision of food and water in this camp and the other five or six camps scattered around the town of Vavuniya, and the gravity of this logistical nightmare becomes clear. That's without even taking into account the 50,000 or more people who have moved to Trincomalee and 7,000 in Jaffna.

The displaced people are mostly frightened and bewildered by the situation. As one told us, "We are grateful for the fact that we have been rescued and fed, but we are scared because we do not know the plan of the army or the government, nor do we understand them because of the language problem."

The test will be to overcome these barriers to allay fear and suspicion. But for now, the immediate need is to provide relief for these weary and apprehensive people.

Reuters AlertNet is not responsible for the content of external websites.