Almost a week after cyclone Nargis inundated Myanmar’s densely settled coast and left untold tens of thousands dead, the United Nations is demanding the military rulers open the country’s doors to supplies and aid workers, writes ANDY NEWMAN

WITH up to 1.5 million people in Myanmar now believed to be facing the threat of starvation and disease and with relief efforts still largely stymied by the country's isolationist military rulers, frustrated United Nations officials all but demanded that the government open its doors to supplies and aid workers.

"The situation is profoundly worrying," said the UN official in charge of the relief effort, John Holmes, speaking in unusually candid language for a diplomat. "They have simply not facilitated access in the way we have a right to expect."

Almost a full week after cyclone Nargis inundated Myanmar's densely settled coast, wiped out villages and left untold tens of thousands dead and hundreds of thousands homeless, the first two UN flights carrying relief supplies arrived in Myanmar on Thursday. One carried a mere seven tonnes of high-energy biscuits, while the other contained a larger load of humanitarian supplies.

Yet emergency supplies on that scale seemed woefully disproportionate to the needs of the survivors, if the scale of the disaster is as extensive as the UN and most international aid groups believe.
Aid officials warned that the slow response to the crisis could ignite epidemics of diseases like cholera and malaria, adding substantially to the death toll. And a prolonged delay could lead to malnutrition and starvation across the vast area affected.

Since the cyclone hit, aid officials said, Myanmar's military rulers have granted visas for aid workers only grudgingly and placed restrictions and roadblocks on supplies coming into the country, while reassuring citizens that it has a grip on the worsening humanitarian crisis.

The official government death toll from the cyclone is 23,000 but the top American diplomat in Myanmar, Shari Villarosa, said the toll could rise to 100,000 if aid did not reach survivors soon. A military official in the town of Labutta estimated 80,000 dead there alone, Agence France-Presse reported.

In the centre of the storm damage, the rice-growing region of the Irrawaddy delta southwest of Yangon, nearly 5,000 square kilometres remained under water. Lone survivors of large families told of dodging bodies and moaning people waiting to die, of villages where all but a few people were killed, of long stretches without an intact building.

"It's a race for time, a race to save lives," said Henrietta Fore, administrator of the United States Agency for International Development.

The Myanmar government's response has drawn international criticism that echoes the condemnation it received after its brutal suppression of demonstrations for change last September. Its usual wariness towards outsiders is widely believed to have been heightened by a national constitutional referendum scheduled for today that would enhance the power of the military junta. The government has barred all outside monitors for that vote.

Myanmar's leaders said they would postpone the vote, but only in the hardest-hit parts of the country. UN Secretary-General Ban Ki-moon spoke with the junta's senior general, Than Shwe, on Thursday to urge him to delay the referendum altogether and to allow aid workers into the country to do their jobs.

There are thousands of aid workers inside Myanmar already. Save the Children has a staff of 500 there and has been able to provide 63,000 families with plastic sheeting, food, water purification tablets and other supplies. CARE has a staff of 500, Doctors Without Borders has staff members there and the UN also has 1,500 personnel in Myanmar.

But the scale of the disaster dwarfs these measures, aid experts say. Without a huge influx of supplies and transportation in the area, where many villages were accessible only by boat or helicopter to begin with, the workers can offer only limited help.

"It's highly frustrating for everyone," said Fore, whose agency has relief teams, helicopters and ships offshore, all waiting for visas. The French and British navies find themselves similarly thwarted. American State Department officials spoke of air-dropping supplies, but said they would not do so without the junta's permission.

Many people in the worst-hit areas have not had any food or safe drinking water or medical treatment since the cyclone hit, said the spokesman for the UN World Food Programme, Paul Risley. The storm has mixed drinking water and sewage, posing a severe risk of diarrhoeal diseases, and flooding has left vast pools of standing water where mosquitoes can breed and spread malaria and dengue fever.

The cyclone struck a country particularly ill-equipped to deal with a public-health catastrophe, said Dr Chris Beyrer, an epidemiologist at Johns Hopkins who has worked extensively in Myanmar. Under the military government, the public health infrastructure has been crumbling for decades.

Malaria is already endemic, and many people with AIDS and tuberculosis are going untreated, he said.

"We don't think the blood supply is safe or adequately screened," Dr Beyrer said, adding that people injured in the storm and in need of transfusions may face the risk of infection and blood-borne diseases.

The military government has sealed the country off from the outside world for decades, and the barriers and the mistrust have grown even higher in recent years with the imposition of economic embargoes.

Political analysts say an influx of foreign aid and experts could undermine the junta's standing with the population by demonstrating its inability to care for its people and by allowing foreign influences into the closed nation.

"The disaster has demonstrated that their omniscient power has been greatly exaggerated," said Sean Turnell, an expert on the Myanmar economy at Macquarie University in Sydney, Australia.

The foreign aid they are resisting "would show them up terribly, organisationally and in terms of equipment, and would be quite a loss of face."

"This is a regime that is extremely close to totalitarian, so I think an infusion of aid around the country would have a big political effect."

In its statements to its people, the ruling junta has insisted that everything is "returning to normal" and that it has the situation under control.

On Thursday, state television showed the prime minister, Lt-Gen Thein Sein, distributing food packages to the sick and injured as well as a film of soldiers dropping food supplies from helicopters over villages. -- NYT