Charity workers are scrambling to avoid a public health crisis in the wake of the Indonesian tsunami that killed at least 429 people as supplies of medicine and clean water dwindle.

Doctors working to limit the fallout from the tsunami that devastated the west coast of Java have warned that children are falling ill and becoming dehydrated.

Thousands of survivors left homeless are living scattered among several buildings rather than in a single rescue area, making it harder to target support.

There are even fears the region could be hit by more deadly waves, bringing new chaos to an area already covered by mountains of overturned cars, boats, furniture and other debris.

More than 1,400 people were injured by the tsunami and at least 154 remain missing, raising fears that the death toll could increase further in the coming days.

Overstretched aid workers are torn between supporting survivors or clearing bodies. Some raised warnings about what they were seeing on the ground.