The death toll has topped 67,000 in Asia and East Africa following the devastating tsunamis that hit the Indian Ocean region on Sunday.

The World Health Organization is warning that the spread of disease, especially malaria and cholera, could end up killing up tens of thousands more people.

Dr. David Nabarro, the head of crisis operations for the World Health Organization, said “The initial terror associated with the tsunamis and the earthquake itself may be dwarfed by the longer term suffering of the affected communities.”

Worst hit have been Indonesia and Sri Lanka. Both countries have lost more than 25,000 people each. The Vice President of Indonesia said his country may have lost as many as 40,000 people. In Sri Lanka the government is estimating 1.5 million people–or nearly 8 percent of the population–is now homeless.