Aid began to trickle into cyclone-ravaged Myanmar late Tuesday but the worst-hit Irrawaddy delta, where nearly 22,000 people reportedly perished, was largely cut off from the rest of the world four days after winds, floods and high tidal waves tore through the densely populated region.
With more than 40,000 still missing and as many as 1 million possibly left homeless, the international community was struggling to deliver aid in the military-ruled country, which normally seeks to shut out foreign officials and restricts their access inside the country.
Concerns mounted over the lack of food, water and shelter in the delta as well as diseases spawned by Cyclone Nargis in a country with one of the world's poorest health systems.
"Our biggest fear is that the aftermath could be more lethal than the storm itself," said Caryl Stern, who heads the U.N. Children's Fund in the United States.
The U.N.'s World Food Program said late Tuesday it has begun distributing aid in damaged areas of Yangon, the largest city, where 800 tons of food had arrived, although the coastal regions were mostly out of reach due to flooding and road damage.
Even in Yangon, electricity remained cut for almost all 6.5 million residents, while water supply was restored in only a few areas. Some residents had to wait for nine hours to fill up their gas tanks.
Ongoing clean-up efforts
Buddhist monks and Catholic nuns wielding knives and axes joined residents in clearing roads of ancient, fallen trees that were once the city's pride. And soldiers were out on the streets in large numbers for the first time since the cyclone hit, helping to clear trees as massive as 15-feet in diameter.
U.S. President George W. Bush called on the country's junta to allow the United States to provide disaster assistance, saying Washington was prepared to move naval assets to help search for the dead and missing.
The U.S. Navy has three ships as well as troops in the Gulf of Thailand, within an easy sail of Myanmar, as part of joint military exercises code-named Cobra Gold scheduled for May 8-21. Thailand, Japan, Indonesia and Singapore will also take part in the annual war games.
The Myanmar military, which regularly accuses the United States of trying to subvert the regime, is unlikely to allow U.S. military presence in its territory.
But reflecting the seriousness of the crisis, the government has appealed for foreign aid and also announced Tuesday that it is delaying Saturday's crucial constitutional referendum in the hardest hit areas.
State radio said Saturday's vote on the military-backed draft constitution would be delayed until May 24 in 40 of 45 townships in the Yangon area and seven in the delta. It indicated that the balloting would proceed in other areas as scheduled.
Pro-democracy advocates, including the political party of detained leader Aung San Suu Kyi, have denounced the constitution as a tool to perpetuate the grip on power of a military that has become increasingly unpopular.
At least 31 people were killed and thousands more were detained when the military cracked down on peaceful pro-democracy protests in September led by Buddhist monks and democracy advocates.
Lack of warning about the storm
Inadequate warnings about the approaching storm and poor reaction by authorities once it struck is expected to further alienate the general population.
The radio said that most of the 22,464 who died, as well as the 41,000 missing, were in the Irrawaddy delta region. It said 671 were killed in the Yangon area.
Images from state television showed large trees and electricity poles sprawled across roads as well as roofless houses ringed by water in the delta, a lacework of paddy fields and canals regarded as Myanmar's rice bowl. Brig. Gen. Kyaw San, the information minister, said tidal waves killed most of the victims in the delta.
The government said it was trying to move in aid and some foreign agencies had managed to send assessment teams, including five from UNICEF.
Richard Horsey, Bangkok-based spokesman for the U.N. Office for the Coordination of Humanitarian Aid, said the airport closest to the delta region was located in Yangon.
"The biggest problem will be to reach the affected areas. There will be a huge logistical problem," he said.
Helicopters and boats would be needed to reach many areas. The delta is riddled with waterways, and Horsey said they are not easily accessible, even during normal times.
"The big concern is waterborne diseases. So that's why it's crucial to get safe water in. Then mosquito nets, cooking kits and clothing in the next few days," he said. "Food is not an emergency priority. Water and shelter are."
Based on a satellite map made available by the United Nations, the storm's damage was concentrated over about a 11,600-square-mile area along the Andaman Sea and Gulf of Martaban coastlines — less than 5 percent of the country.
Millions live in affected areas
But the affected region is home to nearly a quarter of Myanmar's 57 million people.
"Instead of waiting for figures on casualties and damage, it will be practical to send humanitarian aid to victims as soon as possible," Relief and Resettlement Minister Maj. Gen. Maung Maung Swe told a press conference Tuesday.
A C-130 military transport plane flew from Bangkok to Yangon on Tuesday, where it unloaded rice, canned fish, water and dried noodles, which were transferred to a helicopter which Myanmar military officers said would ferry the supplies to the most stricken areas.
The aircraft, carrying in the first aid from abroad, returned to Thailand after about an hour on the ground at Yangon international airport.
Other countries and organizations said they were prepared to follow.
Britain said Tuesday it will contribute up to $9.8 million in initial relief funds and also will send an emergency field team to help with international relief efforts and support foreign aid staff already in Myanmar.
The United States, which has slapped economic sanctions on the country, said it likewise stood ready, but that a U.S. disaster team must be invited into the country.
The White House said later Tuesday the U.S. will send more than $3 million to help victims of the cyclone, up from an initial emergency contribution of $250,000.
Other countries, from Canada to the Czech Republic and Singapore, reacted quickly to the crisis with pledges of aid. China said it would provide $1 million to help with disaster relief and rehabilitation.
The European Commission was providing $3.1 million in humanitarian aid while the president of neighboring China, Hu Jintao, promised assistance without offering details.
French 'don't really trust' military
French Foreign Minister Bernard Kouchner said France minimized its aid to about $309,000. He said Myanmar officials are willing to accept aid but insist on distributing it themselves, which he said was "not a good way of doing things."
"It's not a lot but we don't really trust the way the Burmese ministry would use the money," said Kouchner, who is also the co-founder of French aid group Doctors Without Borders.
Kouchner said, however, that 25 percent of the EU donation was coming from France.
Anne-Francoise Moffroid, the EU desk officer dealing with the crisis, said it was difficult to know how many people will need aid. Affected areas are isolated and difficult to reach and infrastructure has been destroyed, she said.
"Many volunteers from the local Red Cross have died in the disaster," she said. "I think it will be a major challenge to bring assistance to these areas."
Simon Horner, spokesman for the EU humanitarian office, called it "a massive disaster," particularly in the Irrawaddy delta.
"The reports that are coming back from some of our partner organizations ... is that there are some communities where the destruction is close to 100 percent," Horner said.
Until Tuesday, few soldiers were seen helping alleviate conditions in Yangon and while state television showed images of a government truck distributing water, residents said they had not seen any around the city. Instead, people stood in long lines to buy water or carried pails of it from monasteries.
Vendors were selling basic commodities, including rice and edible oil, for twice last week's prices.