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TACLOBAN, Philippines (Reuters) - The death toll from one of the world's most powerful typhoons surged to about 4,000 on Friday, but the aid effort was still so patchy bodies lay uncollected as rescuers tried to evacuate stricken communities across the central Philippines.
After long delays, hundreds of international aid workers set up makeshift hospitals and trucked in supplies, while helicopters from a U.S. aircraft carrier ferried medicine and water to remote areas leveled by Typhoon Haiyan a week ago.
"We are very, very worried about millions of children," U.N. Children's Fund spokesman Marixie Mercado told reporters in Geneva.
A U.N. official said in a guarded compliment many countries had come forward to help.
"The response from the international community has not been overwhelming compared to the magnitude of the disaster, but it has been very generous so far," Jens Laerke of the Office for the Coordination of Humanitarian Affairs told the Geneva news briefing.
Captain Victoriano Sambale, a military doctor who since Saturday has treated patients in a room strewn with dirt and debris in Tacloban, which bore the brunt of the storm, said there had been a change in the pace in the response.
"I can see the international support coming here," he said.
"Day one we treated 600-plus patients. Day two we had 700-plus patients. Day three we lost our count."
President Benigno Aquino, caught off guard by the scale of the disaster, has been criticized for the slow pace of aid distribution and unclear estimates of casualties, especially in Tacloban, capital of hardest-hit Leyte province.
A notice board in Tacloban City Hall estimated the deaths at 4,000 on Friday, up from 2,000 a day before, in that town alone. Hours later, Tacloban mayor Alfred Romualdez apologized and said the toll was for the whole central Philippines.
The toll, marked up on a whiteboard, is compiled by officials who started burying bodies in a mass grave on Thursday.
Romualdez said some people may have been swept out to sea and their bodies lost after a tsunami-like wall of seawater slammed into coastal areas. One neighborhood with a population of between 10,000 and 12,000 was now deserted, he said.
The City Hall toll was the first public acknowledgement that the number of fatalities would likely far exceed an estimate given this week by Aquino, who said lives lost would be closer to 2,000 or 2,500.
Official confirmed deaths nationwide rose by more than 1,200 overnight to 3,621 on Friday. Adding to the confusion, the United Nations, citing government figures, put the latest overall death toll at 4,460, but a spokeswoman said it was now reviewing the figure.
"I hope it will not rise anymore. I hope that is the final number," Eduardo del Rosario, director of the National Disaster Risk Reduction and Management Council, said of the latest official toll. "If it rises, it will probably be very slight."
On Tuesday, Aquino said estimates of 10,000 dead by local officials were overstated and caused by "emotional trauma". Elmer Soria, a regional police chief who gave that estimate to media, was removed from his post on Thursday.
National police spokesman Reuben Sindac said Soria had experienced an "acute stress reaction" and had been transferred to headquarters in Manila. But a senior police official told Reuters he believed Soria was re-assigned because of his unauthorized casualty estimate.
But massive logistical problems remain. Injured survivors waited in long lines under searing sun for treatment. Local authorities reported shortages of body bags, gasoline and staff to collect the dead.
"Bodies are still lying on the roads. But now at least they're in sections with department of health body bags," Ian Norton, chief of a team of Australian aid workers, told Reuters.
Stunned survivors in Tacloban said the toll could be many thousands. "There are a lot of dead people on the street in our neighborhood, by the trash," said Aiza Umpacan, a 27-year-old resident of San Jose, one of the worst-hit neighborhoods.
"There are still a lot of streets that were not visited by the disaster relief operations. They are just going through the highways, not the inner streets," he said. "The smell is getting worse and we actually have neighbors who have been brought to hospital because they are getting sick."
The preliminary number of missing as of Friday, according to the Red Cross, rose to 25,000 from 22,000 a day earlier. That could include people who have since been located, it said.
The nuclear-powered USS George Washington aircraft carrier and accompanying ships arrived off eastern Samar province on Thursday evening, carrying 5,000 crew and more than 80 aircraft.
U.S. sailors have brought food and water ashore in Tacloban and the eastern Samar province town of Guiuan whose airport was a U.S. naval air base in World War Two. The carrier is moored near where U.S. General Douglas MacArthur's force landed on October 20, 1944, in one of the biggest Allied victories.
Acting U.S. Ambassador Brian Goldbeck, the chargé d'affaires at the U.S. Embassy in Manila, said the United States had moved 174,000 kg (383,000 lb) of emergency supplies into affected areas and evacuated nearly 3,000 people.
A Norwegian merchant navy training vessel arrived at Tacloban on Friday with goods from the U.N. World Food Programme, including 40 metric tons of rice, medical equipment and 6,200 body bags.
Boxes of aid were being unloaded at Tacloban's badly damaged airport, where more than a thousand people queued for hours hoping to evacuate.
Hundreds of people, part of nearly a million who have been displaced by the storm, lined up for food and drink at an evacuee processing center at Mactan Air Base in Cebu, the country's second-biggest city.
Some 522 evacuees passed through the center on Thursday, with hundreds more arriving on Friday, a government coordinator, Erlinda Parame, said.
In one room, children huddled on a mud-streaked floor watching cartoons on a small television.
Nearby, Gerardo Alvarez, 53, sat strapped to a metal wheelchair, straining against the bandages that restrained him.
"The water is coming! I'm going to die!" he shouted.
The traumatized man had escaped the storm surge from a second-storey window of his Tacloban home while his sister and mother, who were praying downstairs, drowned.
Additional reporting by Rosemarie Francisco and Eric dela Cruz and Manuel Mogato in Manila, Michelle Nichols at the United Nations and Stephanie Nebehay in Geneva. Writing by Jason Szep. Editing by Dean Yates and Nick Macfie