(CNN) -- Aid efforts to earthquake-ravaged Sumatra are being hampered by the level of destruction, amid reports the situation is worse than expected on the hardest-hit island of Nias.
Many of the roads on the island are impassable and the only link to the airport is cut, restricting the delivery of urgently needed aid, which is starting to arrive on the island 48 hours after the quake struck.
About 600 people have been confirmed dead in Nias from Monday's 8.7 magnitude tremor, but that toll is expected to rise substantially as the extent of the destruction and injuries become apparent.
Australian military aircraft have begun flying additional medics and supplies to the region as the island's only hospital was all but destroyed.
Little or no electricity and fuel is forcing doctors to tend to the injured, many suffering compression and crush injuries, without power.
"Reports that I've had in now overnight are, I must admit, pretty bad," Australian Foreign Minister Alexander Downer told Australia's ABC Radio Thursday.
"There's no doubt about this being a significant humanitarian crisis and the Indonesians have deployed resources very quickly, but we're obviously ready to provide additional assistance if it's needed and it may very well be needed," Downer said.
Indonesia has said it welcomes help and President Susilo Bambang Yudhoyono is expected to arrive on the devastated island today.
Indonesia "welcomes and is open to all kinds of assistance, including help from foreign troops, to assist in the disaster zone," a spokesman for the President told The Associated Press.
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