BEUTONG ATEUH, Indonesia - On a slippery strip of mud, a dozen pickup trucks descended the mountains toward the west coast of Sumatra, the area worst hit by the earthquake and tsunami that ravaged the region.

Some members of the convoy were bringing food and water to relatives who had lost virtually everything. Others were returning home, bracing themselves for horrors on the stretch of the Indian Ocean coast where tens of thousands of people are believed to have died.

Headed in the opposite direction, trucks crammed with families escaping the catastrophe struggled to make the ascent, their wheels spinning in the brown ooze as men pushed the vehicles from behind. In the center of the road, a three-foot ditch snared the wheels of one car after another, tires spinning in the mud as engines roared in futility. Then, as if things could get any worse, it began to rain.

This steep, winding road through jungle-covered mountains in the Indonesian province of Aceh amounts to the greatest potential lifeline to communities suffering from a natural disaster that will surely be remembered for generations. It is also a primary bottleneck in the Indonesian relief effort. The road is barely passable in places, a river of muck impervious to most vehicles. It is also the only available overland route to the devastated towns and villages on the west coast of Sumatra, where thousands still wait for outside aid.

A drive Wednesday and yesterday from the east coast of Sumatra toward the town of Meulaboh on the west coast - the place of greatest concern -underscored the extent to which the area has been cut off, complicating efforts to ferry in food, water and medical help. About 100 miles separate the mountain town of Takengon from Meulaboh, a trip that took some vehicles as long as two days.

A relatively modern highway once connected the provincial capital, Banda Aceh, to Meulaboh. But the Dec. 26 earthquake and tsunami destroyed bridges and stripped away pavement, leaving this little-used, largely dirt road as the only way in.

In recent days, international aid groups have expressed frustration about their inability to reach the west coast.

The U.N. World Food Program, which has delivered more than 400,000 tons of food to Banda Aceh, had yet to survey the overland route to Meulaboh and was unsure if the town could be reached by truck.

"The question on everybody's mind is what about the west coast," said Michael Elmquist of the U.N. office coordinating the relief effort for Indonesia during a news conference this week. "Very few of us have had a chance to see the west coast."

Since last week, U.S. Navy and Singaporean military helicopters have been airlifting supplies of food and water. Senior relief officials say such operations are crucial to the effort to prevent immediate hunger and dehydration. Still, aid has been insufficient, according to refugees leaving Meulaboh.

"I never received anything," said Rufni Abdullah. Her 14-month-old son was tied to her waist in a batik sarong as she made her way toward her father's house more than 60 miles away. "There's no place to stay and no more food to eat."

Aid workers consider the first three months of the relief mission as critical, the period in which massive infusions of food, water and medicine are needed to stave off disease. Helicopters cannot be relied upon for everything because they cannot carry heavy enough loads.

"Ideally, one would like a lot more," said Peter Holdsworth, an Africa-based rapid-response coordinator for ECHO, Europe's emergency aid delivery arm, now shifted to Indonesia. "You need to get other systems in place," he said, adding that road and bridge repair must be pursued aggressively.

All of which explains how the condition of this primitive road through mostly empty country in the center of Sumatra has suddenly become a question of life and death.

As traffic moved Thursday, measuring progress in yards, men ran alongside vehicles clearly unsuited to the terrain - panel vans, front-wheel-drive pickups - throwing rocks in their path to apply brakes as the tires skittered down the slick surface.

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