Muhammad Siadi had the vacant stare of someone who might have just returned from a war zone. His shirtless, wiry frame was covered in injuries: a large gash in his neck, a shaved circle around a few bumps on his head and a spray of grazes from his shoulder to his back.

On Friday night he had been at home in Sigi, Palu, on the Indonesian island of Sulawesi, changing the gas for his wife when the 7.5 magnitude earthquake struck. The quake caused a wall to collapse on his back and a piece of corrugated iron gouged into his neck.

Play Video 1:04 Indonesia tsunami: drone footage shows trail of destruction in Palu – video

As the house caught on fire, Siadi made the harrowing decision to leave his dying wife, trapped under the rubble, so that he and his son could get out alive. They tried to pull her out but there wasn’t time.

Four days after the disaster, he had finally received medical assistance for his neck injury, but like everything in Palu, it hadn’t happened quickly enough.

“It comes too late,” said Siadi as he fingered a silver strip of medication. “The doctor said I needed stitches, but now it’s too late because the skin is already dead, it won’t join back.”

Facebook Twitter Pinterest Muhammad Siada Photograph: Kate Lamb

In Palu and its surrounds, people are being pushed to the brink. The earthquake and tsunami killed nearly 1,400 people, destroyed thousands of homes and displaced 59,000. Without enough food, water or fuel, survivors are desperate.

On Monday hundreds descended on Palu’s airport begging for food or a flight out. Authorities had to temporarily shut the airport. Other people have been looting supermarkets and convenience stores or trying to raid cash machines. At least 1,400 prisoners are on the loose after prison walls crumbled.

Facebook Twitter Pinterest Quake survivors scuffle to get live chickens being distributed from a police truck outside a makeshift camp in Palu. Photograph: Jewel Samad/AFP/Getty Images

On Tuesday evening half a dozen police officers with automatic rifles were guarding long queues of frustrated residents and their gerry cans at a Palu petrol station. Hengki, a local resident, said he had been waiting for almost eight hours in the searing heat. “I survived a disaster and now I have to survive this?” he asked, visibly agitated.

Others in the queue chimed in with shared anger and disgust. “The government doesn’t care about us,” said another resident, Yuli, repeating a refrain seen spray-painted on at least one Palu city wall.

Help is on the way but those on the ground say it isn’t coming quickly enough. On a drive up from Makassar, convoys of trucks filled with supplies could be seen on the road, accompanied by police escorts. Other aid is on the way by air and sea.

Facebook Twitter Pinterest People take gasoline from a closed gas station in Palu. Photograph: Beawiharta/Reuters

Logistics are invariably challenging in Indonesia, especially in its remote eastern regions. Damage to roads and to the airport runway has compounded the difficulties of getting supplies to where they are needed most.

Some refugees camped out in the hills for days have not received anything at all. Andi Irwan, who lives hours away, was ferrying kilos of rice and other supplies to his brother, who was camped out there. “He has money,” said Andi of his brother, “but it is useless, there is nothing to buy.”

Driving the coastal road into Palu, everything was askew, entire villages reduced to rubble – a mess of wood and concrete blocks and the odd car or truck, chewed up and spat out like a piece of gum.

Iswa, 46, who lost everything except the checked shirt on his back after the tsunami upended his home, said people didn’t know what to do. When he had seen the water start to bubble up and then recede, his gut instinct was to run up the hill. When he came back down in the morning, everything was in ruins.

The local government had given Iswa and his neighbours some rice and noodles but nothing to drink. “I know people are looting,” he said in front of what was once his house. “But we have no choice. What else are we supposed to do?”