Plight of Kurds Grows Worse : Refugees: Thousands more may die before relief arrives, officials say. A huge truck caravan is en route to the Turkish border area as aerial aid drops continue.

Despite a mammoth American-led relief effort, the plight of half a million refugees perched in agony along the mountain border between Iraq and Turkey is worsening alarmingly. Thousands may die before help comes, Turkish officials, international aid specialists and foreign diplomats warned Monday.

“We’re on the losing end of this one right now,” said Donald M. Krumm, a senior State Department official coordinating the U.S. effort. “The international system is not on top of it. The death rate is mounting. We are desperately trying to catch up in a survival kind of situation.”

American, British and French planes dropped more aid by parachute Monday. A caravan of 79 trucks loaded with U.S. food and clothing was en route to the border. U.S. military reconnaissance teams searched for sites on which to build forward helicopter bases for supply and distribution.

In other developments:

* Iran said an Iraqi army brigade drove nearly two miles into its territory and attacked Kurdish refugees, killing a number of them and closing off an escape route, wire services reported. Tehran Radio said the Sunday night attack occurred opposite the Iranian border town of Sar-e Pol-e Zahab, 320 miles southwest of Tehran.

* On the Iran-Iraq border, the Iranian government set up tent camps and worked desperately to care for hundreds of thousands of Kurdish refugees, their numbers growing every day. But children, weakened by their travel ordeal, were dying even after reaching medical care.

Up to 8,000 noncombat American troops will participate in the relief effort on the Iraqi-Turkish border, but it will be many days before the first American site is operational. Meanwhile, international and private relief agencies are grappling for some kind of leverage, humbled by the magnitude of the relief task and the hellish logistics.

The Turkish government moved 2,500 of a planned 20,000 refugees Monday from one mountain concentration of 150,000 to a hospital-equipped camp. The transfer of all 20,000 will take a week. Overriding objections within his own government, President Turgut Ozal agreed to allow up to 40,000 refugees to move to flatland camps, diplomatic sources said, but he is steadfast in refusing to offer permanent asylum. Turkey feels that if it opened its border, the influx of Kurds would be overwhelming.

In addition to the 500,000 refugees on the Turkish border, Iran--which has opened its own border with Iraq--says it has taken in 1 million fleeing Iraqis. Another million are reportedly waiting to cross the frontier, according to reports from Tehran, which said Monday that Iranian relief agencies were running out of supplies.

Here in the Turkish capital, the professionals overseeing the relief effort applauded the small victories being won daily in the Turkish southeast, but in interviews they were glumly unanimous in warning of tragedy for the mostly Kurdish refugees fleeing Saddam Hussein.

“The situation is unbelievably bad--and it is getting worse and worse,” said one West European ambassador. “We fear that there will be a large number of deaths in coming days.”

Said an American official: “Our effort is growing, but I wish it was going faster. The situation is not yet stabilized--no way.”

“Our biggest worry is measles,” a senior international relief planner said. “If children are not immunized soon, there is danger of a big epidemic. It could be catastrophic.”

Health Minister Halil Sivgin told Turkish reporters: “World public opinion has remained insensitive. Aid must be sent immediately. Otherwise it will not reach its target.”

A team of four American doctors representing a Massachusetts-based group called Physicians for Human Rights surveyed conditions among the largest concentration of refugees--around 150,000--on both sides of the border near the Turkish town of Cukurca. The doctors found that 40% of the refugees were under age 5, and although 20% of the women were breast-feeding, fewer than half of them were lactating because of malnutrition, dehydration or stress.

There were around 30 doctors and 10 nurses among the refugees, who appeared to be principally urban and included engineers, teachers, Muslim clerics, city officials and other provincial notables.

The American doctors estimated the death rate among the refugees near Cukurca at about one per 1,000 each day. Taking a high estimate of 700,000 refugees along the border, the doctors estimated a daily death total of 400 to 1,000. “This figure will increase unless there is immediate intervention,” the doctors said in a report.

In the Turkish mountains, where there is no sanitation or clean water for the refugee thousands, infants and children die quickest of maladies such as diarrhea and dehydration. “Virtually all these deaths are easily preventable,” the doctors said.

Like the rest of the international community, the United States has been blindsided by the suddenness and the immensity of the crisis.

“Imagine that half a million hungry and cold people turned up one morning in the Sierra Nevada needing to be sheltered and fed. Would that be easy to organize?” asked one hard-pressed American official.

After the American victory in the Persian Gulf War, Iraq’s 4 million Kurds rebelled against Hussein’s regime, claiming by mid-March to control almost the entire north of Iraq.

Then, after suppressing a Shiite Muslim revolt in southern Iraq, Hussein struck back savagely. The Iraqi army defeated Kurdish insurgents easily and attacked civilians in retribution, refugees say. The exodus of the Kurds began across the 1 1/2-mile-high mountains, with merchants in shiny Mercedes-Benzes and peasants on limping mules riding through the snow.

Before the war, United Nations agencies had projected that Turkey might expect 20,000 refugees in the aftermath. They laid in stocks for that number.

But by early this month the numbers were beyond comprehension--and the capabilities of any combination of relief agencies to meet.

Last Friday, President Bush, employing American armed forces for such massive relief work for the first time, promised to deliver 700,000 meals a day for a month to the refugees. When the month is up, the plan is then to turn over the refugees’ sustaining care to Turkish, international and private agencies, who will have stocked their larders in the meantime.

All that is proving easier to plan than to execute, American and international relief specialists agree. The refugees are stuck in a region that is remote and forbidding in the best of times. They have endured snow and rain with scarce food, little shelter and no organization. Now there is mud.

“The conditions in which everyone is trying to operate are practically impossible,” David Jones, deputy director of the British relief group Oxfam, told the British Broadcasting Corp. on Monday. “The hillsides are seas of mud. They are like a First World War battlefield. There’s only one track up to the one I went to. It’s just impossible to supply that. The only solution is to get those people off the hill. . . . It is a crime against humanity to leave them there.”

Compounding the suffering and vastly complicating international access, the refugees have had the bad luck to arrive there during a strike that has robbed Turkey of its major internal air service. And this week, when the true dimensions of the crisis are at last becoming clear, Muslim Turkey is observing the week of annual end-of-Ramadan holidays.

“It is impossible to service the refugees where they are now,” said one United Nations planner. “You can’t build camps on slopes. Water and sanitation are impossible. Logistics is a nightmare.”

Relief experts would like to move the refugees into planned areas inside Turkey or in Iraq, but politics intrude.

Turkey, which has a restive Kurdish population of its own, lacks both the resources and the patience to accept the Iraqi Kurds, who have a long tradition of rebellion--against the countries where they live and against one another. Neither is any other country willing to offer them permanent asylum.

In 1988, under strong pressure from Western countries, Turkey accepted 60,000 Iraqi Kurds fleeing Hussein’s regime. At least half of them still live in refugee camps in southeastern Turkey.

Now, Hussein is urging the refugees to return home, promising no reprisals. But few will go, say Turkish officials and foreign diplomats, without long-term international guarantees for their safety.

The Iranian Border

On the Iran-Iraq border, meanwhile, Iranian relief authorities were trying Monday to care for hundreds of thousands of Kurdish refugees, with tent camps beginning to shelter many thousands. But it was clearly an uphill effort.

Food, medicine and shelter were in short supply, and babies, weakened from diarrhea, were dying even after reaching medical tents.

Along the border roads, mothers held babies up to passing vehicles, pleading for help. Children could be seen at the roadside, appearing to nod off, with no adults nearby.

Some Kurdish refugees reported that mothers had left their children behind in Iraq when they realized they would not survive.

One old man lay motionless by the road, clutching his cane, his eyes closed, as people stepped over him.

Not far away, families set up housekeeping beside a stream, making cooking fires and slaughtering small animals that they may have caught since arrival.

What seemed an endless line of Kurds passed into Iran through the Iranian border post at Shushami, some on foot, others packed into cars, trucks, buses, taxis, tractors and construction equipment. The line of vehicles snaked back into the mountains of Iraq for what seemed to be 25 miles.

Kurds on foot were allowed in immediately, but the line of vehicles crept forward with painful slowness as Iranian border police searched for alcohol, weapons and other contraband.

Some Kurds who could not wait left their vehicles and walked to the border, where refugee workers in trucks tossed out boxes of bread, blankets, and other necessities. Then the travelers returned to their waiting cars miles down the road.

The Iranians were settling thousands of Kurds in tent camps on mountain meadows along the Sarwan River. In the camps, mothers washed babies, families showered under small waterfalls and small boys wandered the rough terrain picking up brushwood for fires. Food was distributed by dump trucks filled with cartons of flat Iranian bread.

As the sun rose over the Sarwan Valley, it caught the light blue haze of hundreds of tiny cooking fires, creating a strange mist.

At 5 a.m., a loudspeaker broadcast a muezzin’s call to morning prayer, the chant resounding over the quiet valley at the junction of two rivers, the Sarwan and Doiab.

The camps are dotted along a 25-mile stretch of twisting road overlooking a spectacular gorge of the Sarwan River as it cuts through beige rock between 9,000-foot peaks in the area known historically, although unofficially, as Kurdistan.

At Shushami, the Iranians set up three tents under the auspices of the Red Crescent Society--the Muslim nations’ equivalent of the International Red Cross--to treat the arriving Kurdish refugees.

The Iranian doctor in charge, Sadegh Nomati, pointed to the three tents and said, with a trace of irony, “This is my hospital.”

One tent was for rehydration, one for supply; the third was his office.

Outside his tent, a family displayed a 5-year-old son whose face was badly burned. They said the Iraqi military had attacked them with incendiary phosphorus shells as they were beginning their trek to Iran.

Dr. Rashid Azad, a Kurd from Halabja--the Iraqi town that Hussein’s regime attacked with chemical weapons in 1988, when its population was suspected of aiding the Iranian enemy--said, “The greatest problem is gastroenteritis, for which we need antibiotics and milk for children.”

In the next tent, a nursing assistant, Henna Ali, 28, a Kurd from Kirkuk in Iraq, passed out antibiotics and injectable saline solution, the latter for the dysentery that is widespread among the refugees and can be fatal to the very young.

“We badly need medical supplies for dysentery, which all of us have,” said Ali.

Across the road from the tents was a newly established cemetery with several graves.

The U.N. High Commissioner for Refugees, Sadako Ogata, flew to Shushami by helicopter Monday and said she was impressed by the Iranian effort to accommodate what she called “the fastest-moving” refugee movement in history.

Almost all the refugees interviewed said they did not trust Iraqi President Hussein’s offer of amnesty and preferred an uncertain future in Iran to risking imprisonment or death back in Iraq.

One of the refugees was a 20-year-old student named Negham, a non-Kurdish Shiite Muslim, who said she and her husband, who did not want to join the Iraqi army, fled from their home in Baghdad, the Iraqi capital. Along the way, she said, between 10 and 15 small children died each day.

The bulk of the Kurdish-speaking refugees are Sunni Muslims. Most Shiites who have fled Hussein’s regime are Arabs, not Kurds, and have headed toward the Arabic-speaking part of Iran much farther to the south.

Negham said the Kurds have been generous to her and her husband, and added, “This is not just a problem for the Kurds but for all Iraqis getting away from Saddam.”

A man named Subhi, 36, said that he disguised himself as a soldier and fled Kirkuk--a Kurdish city ravaged by Hussein’s crackdown on the insurgency--and that when he left, he saw “dogs eating dead people in the street.”

Montalbano reported from Ankara and Tuohy from the Iran-Iraq border.