Burma Faces 'Public Health Catastrophe,' Charity Says

By Amy Kazmin
Washington Post Foreign Service
Monday, May 12, 2008

BANGKOK, May 11 -- An estimated 1.5 million Burmese are on the brink of a "massive public health catastrophe," the British charity Oxfam warned Sunday, as survivors of Cyclone Nargis poured out of the devastated Irrawaddy Delta into regional towns in search of water, food and other help.

Burma is facing a "perfect storm" of conditions that could lead to an outbreak of waterborne disease, said Sarah Ireland, Oxfam's regional director.

"The ponds are full of dead bodies, the wells have saline water, and even things like a bucket are in scarce supply," Ireland said.

She appealed for Burmese authorities, who have restricted access to the country, to allow humanitarian agencies to send in technical and health experts to help prevent outbreaks of disease.

The struggling relief efforts suffered another setback when a boat ferrying rice, drinking water, clothing and other aid sank in the delta early Sunday, apparently after hitting a submerged tree, the International Federation of Red Cross and Red Crescent Societies said.

Residents were able to salvage some of the supplies, meant for more than 1,000 survivors, but river water contaminated the food, the organization said. All of those aboard made it safely to land. The boat was carrying one of the first international aid shipments.

"This is a great loss," said Aung Kyaw Htut, who is supervising the distribution effort. "This would have been our very first river shipment, and it will delay aid for a further day."

The cyclone and powerful tidal sea surge ripped across the low-lying delta a week ago. The country's ruling junta on Sunday raised its official tally of the dead to more than 28,000, though humanitarian experts say the toll could run much higher. Thousands remain missing.

The dire warnings came as Burma's state media declared success in a referendum to secure public endorsement of a new constitution that critics say would perpetuate and legitimize military rule. Burma's leaders say the charter will lay the foundation for a "discipline-flourishing democracy."

With conditions in the delta increasingly desperate, survivors began besieging small towns, searching for help. In the town of Laputta, which lost 85 percent of its buildings, about 28 makeshift camps have sprung up. But supplies are limited.

U.N. agencies and international charities that were operating in Burma before the disaster have been slowly setting up aid operations. Emergency supplies are gradually arriving in the country and just beginning to reach the Irrawaddy Delta, but they are far short of what is needed.

"Time is really of the essence. Already we have seen a diarrhea outbreak in the very urban areas of [Rangoon], and with cyclones you'd usually see pneumonia soon as well, and also malaria because of the standing water," said Naida Pasion, the Burma program director for Save the Children, which maintains a staff of 500 in the country.

The World Food Program, which on Friday accused authorities of impounding planeloads of emergency food, said cargo and materials sent since then had been released and sent to disaster zones. The International Committee of the Red Cross also sent a planeload of supplies Sunday, including body bags.

Yet a week on, most survivors have not yet received any help, because of the lack of supplies and logistical difficulties.

"Beyond the main arterial roads, it's a massive challenge, not only because the floodwaters are still there, but also because even when they are not, it's extremely difficult to navigate," said Marcus Prior, a WFP spokesman.

The Burmese army insists that it can manage the massive relief operation and has rebuffed offers from the United States, its longtime critic, and countries in the region for military assistance to distribute aid.

But for years, Burma's military has struggled to feed its own. Vegetables are often grown alongside the runways of army airfields, and chicken coops are usually kept behind barracks across the country, officially known as Myanmar. Troops in far-flung places have long been ordered to "live off the land" because the army command has been unable to reliably supply its 400,000-member force with the food it needs.

"The logistical system in Burma is so shaky that in the 1990s, they told regional commanders and bases outside Rangoon [the country's main city] that they had to take care of their own logistics" for basic needs, said a Western analyst who has studied Burma's military.

Military analysts warn that Burma's army has neither adequate equipment nor training to cope with the crisis, and its insistence on going it alone -- or through its own "strenuous labor" as state media call it -- could cost many lives.

"Disaster relief operations, like any military operation, require training, practice and equipment," said Robert Karniol, a regional defense writer. "Even if they were well practiced, they would have difficulties responding because of the scale."

Humanitarian groups are reluctant to cooperate with foreign militaries in disaster response. But the 2004 Indian Ocean tsunami and the 2005 earthquake in Pakistan showed how foreign militaries could use specialized transportation equipment to move large quantities of supplies to hard-to-reach areas.

The Irrawaddy Delta presents the type of logistical challenge best suited for military hardware. Vast areas remain submerged, accessible only by boat or helicopter, and the region's ports are inaccessible to civilian ships as a result of the damage.

"The Myanmar military has certain assets, but in a response this size, you need to start using everything you've got," said Sebastian Rhodes Stampa, a civil-military liaison officer with the U.N. Office for the Coordination of Humanitarian Affairs.

"In a disaster of this scale, because of the critical needs and limited infrastructure, we would certainly advocate considering the kind of specialized capacities that foreign militaries can give in reaching the people we need to reach," he said.

Burma has allowed foreign military cargo planes to ferry supplies to the Rangoon airport but has so far refused other foreign military help.

"The regime's hope is that they will be able to weather the storm of criticism and just get the aid in and handle it themselves," the Western military expert said. "If that means they can't do enough quickly and some people die, they'll accept that."

Yet the drama could have unforeseen repercussions for a military still shaken by a crackdown in September on Buddhist monks protesting against the government.

The military expert said a disaster-relief failure, and the unnecessary loss of many lives, could undermine the morale of an institution that is built around the notion of safeguarding the Burmese people.

"There must be a great many people in the armed forces who do genuinely care about what has happened," he said. "If they hear that aid is being refused, or put in a [warehouse] and not being released, that does have the potential to impact troop morale and cohesion. And anything that shakes the cohesion and loyalty of the armed forces will shake the regime."