DEYANG, China — Last week's earthquake in Sichuan Province brought Zhang Xianghui's house down on top of her, crushing her lower right leg. Relief workers finally reached her hamlet Sunday and brought her to a hospital here. By evening, doctors had amputated her leg below the knee.
"It smelled bad," one doctor said. "She had gangrene."
Six days after a 7.9-maginitude earthquake struck China's western provinces, causing a death toll that has officially risen to 32,476 but is expected to top 50,000, doctors here are confronting a horrible reality among the ruins: many of those who survived the quake are facing conditions that still threaten their lives.
Deep infections and rotted limbs are just part of the problem. The World Health Organization is warning that China must ramp up efforts to ensure safe drinking water, adequate food and proper sanitation at camps where tens of thousands of homeless survivors fleeing from the mountains have taken refuge.
China says no disease outbreak has yet emerged from the quake zone, where 36,000 doctors, nurses and other medical personnel treat 122,252 people admitted to hospitals. Relief workers in towns leveled by the quake, wary of disease, sprayed disinfectant on rubble, and the Health Ministry voiced concern that cholera may emerge.
But conditions for such outbreaks remain ripe, and the danger in the area of the quake persists. On Sunday, at least three people died when a 6.0-maginitude aftershock struck the city of Jiangyou.
"The main needs now are water, sanitation and food. Ensuring supply of food and safe drinking water and trying to restore good sanitation are critical because these are the basic transmission routes for communicable diseases," said Dr Hans Troedsson, the WHO chief in China.
More than 15 million houses collapsed in Sichuan, Gansu, Shaanxi, Chongqing, Yunnan and Hubei provinces, and 5.7 million people were evacuated, a WHO statement said.
China announced three days of national mourning to begin Monday with a three-minute silence at 2:28 p.m. local time (2:28 a.m. EDT), exactly a week after the quake struck Sichuan. Air raid sirens will sound, as well as horns of vehicles, trains and ships.
For the first time in China's modern history, national flags are ordered to fly at half-staff. Authorities said the Olympic torch relay would also be suspended for three days.
President Hu Jintao expressed gratitude for the arrival of international aid and noted that "relief is still a grim struggle, the task is arduous and time is pressing."
Two U.S. military C-17 aircraft landed in Chengdu, the Sichuan capital, carrying 15,000 meals, tents, blankets, lanterns, generators and hand tools. The planes came from Hawaii and the U.S. Pacific territory of Guam. The state Xinhua news agency said the supplies were worth $1.6 million, and marked the first donation by a foreign military.
Several buried victims were dug out alive Sunday, Xinhua said.
One man, Tang Xiong, was conscious and had cuts and bruises when he was found in Beichuan county north of Chengdu 139 hours after the quake, it reported.
Even so, attention appeared to be turning from rescue efforts to the mounting problems of homeless survivors.
At the Jiuzhou sports stadium in Mianyang, a city in the flatlands west of the quake's epicenter, thousands of survivors camped on blankets in the stadium's corridors and in blue tents on its periphery.
The Sichuan New Online website said tens of thousands of homeless people huddled in appalling conditions in the quake-stricken town of Maoxian, badly in need of assistance.
Streams of survivors, some carrying all the belongings they could scrounge from the rubble of their homes, were walking toward the lowlands.
Despite mounting challenges, doctors at the 800-bed Deyang People's Hospital said they were weary but thankful for arriving teams of additional medical personnel.
"We have more support from other hospitals," said hospital Director Zhao Luping.
The atmosphere in tents scattered around the hospital grounds to deal with the overflow 1,300 patients, and in the wards, appeared surprisingly resilient.
Xiao Zeyi, a 45-year-old farmer from the village of Sanjiang, was at his wife's side when an air force rescue team brought them into the hospital in the afternoon. Xiao's 43-year-old wife moaned on her bed, her amputated leg under a blanket.
"She's very strong," Xiao said. "We feel very lucky. It is good we are still alive."
Xiao was out in the open air working in fields when the quake struck with such devastating force that his village was virtually wiped out.
"It's all destroyed. We can never go back," Xiao said.
The hospital's deputy director, Zhang Biao, said he's concerned that Xiao's family, like many quake survivors, will face psychological crises once the reality of the calamity sinks in.
"It will take time for them to feel really sad. They are still in the emergency room. They are still numb," Zhang said.