According to the country's National Disaster Relief Coordination Agency, around 130,000 people were dead and 37,063 were missing;[1] deaths included 126,602 in Aceh and 130 in North Sumatra.

However, most of the damage was the result of the tsunami that struck the coastal regions of the Aceh and to a much lesser extent the North Sumatra provinces.

Ten-meter tall waves passed the northern tip of the island to race south down the Straits of Malacca and strike along the northeast coast as far east as Lhokseumawe.

In many towns and villages, concrete pads were all that was left of substantial structures, while scattered corrugated iron roofs crumpled like paper wore the only evidence of weaker homes.

The western districts of Aceh, lying nearest the epicenter of the magnitude 9.2 earthquake that caused the tsunami, were a "roadless" area, according to UN Emergency Coordinator Jan Egeland.

"The lack of access by road is a key problem aid agencies face in the northern and western parts of Aceh," Chris Lom, a spokesman in the region for the International Organization for Migration, said on 7 January.

"An escalation in the number of deaths is almost a certainty," according to William Hyde, Jakarta-based emergency relief coordinator for the International Organization for Migration.

UN Secretary-General Kofi Annan described the devastation in the Indonesian province of Aceh as the worst he had ever seen, after touring the region by helicopter on Friday 7 January 2005.

[7] Over one thousand bodies found on the streets in the provincial capital of Banda Aceh were placed in mass graves without waiting for identification as officials quickly tried to keep the sanitation situation from worsening.

Media reports stated that the tsunami was directed by seaside limestone cliffs towards Leupung, which had a population of ten thousand.

[9] The town of Meulaboh, which had a population of 120,000 before the tsunami, was struck by a series of waves, killing an estimated 40,000 and destroying most parts of the city, according to relief organizers and local government officials.

An Indonesian Navy ship bringing aid supplies to Meulaboh was forced to turn away after it was unable to dock because the port facilities were destroyed.

Only five of the 70,000 villagers on Simeulue were killed, all of them in the earthquake, although 90% of the buildings along its coast were destroyed by the tsunami, which reached up to 5 m (16 ft) high.

[18] Confirmation and communications to the islands were further hampered by damage to telecommunication infrastructures, where phone lines were broken and radio networks were said to be down due to bad weather.

The unmanageably high number of corpses strewn all over the cities and countrysides, limited resources and time for identifying bodies, and the very real threat of cholera, diphtheria and other diseases prompted emergency workers to create makeshift mass graves.

The United Nation's Children's Fund reported on Thursday[clarification needed] that aid for 200,000 people, including medical supplies, soap and tarpaulin, was being held at Jakarta for a day to clear customs.

In the immediate aftermath, one of the most pressing concerns was the inability to distribute sufficient aid due to a lack of accessible roads and a shortage of available helicopters.