'We know that (up to) 1.5 million are at risk of further suffering,' Britain-based Oxfam's East Asia director Sarah Ireland said yesterday.

She cited a 'perfect storm' of a lack of fresh water, sanitation and food, plus impending heavy rain in the disaster zone, that could potentially cause a 'massive public health catastrophe'.

'It is not the time for politics; it is the time to get aid in there,' she said, referring to criticism that the junta's bureaucratic red tape has delayed the transfer of some supplies to the affected Irrawaddy delta region and held up visas to foreign relief experts.

There was more bad news yesterday when a cargo boat loaded with the first shipment of Red Cross relief supplies sank after hitting an object near Bogalay, a town badly hit by the cyclone.

Said Mr Samson Jeyakumar, a regional director of World Vision, which has a staff of more than 500 - mostly locals - in Myanmar and a relatively good working relationship with the government: 'What is critical at the moment are water sources, which are full of dead bodies.'

He said many freshwater wells had also been contaminated by sea water.

The dreaded waterborne disease cholera 'can happen any time', he added.

Mr Jeyakumar cited similar disasters in the past. In 2004 after a flood in Bangladesh, there were 17,000 cases of diarrhoea. In 1998 after floods in the Indian state of West Bengal, there were more than 16,000 cases.

Ms Veronique Terrasse, a spokesman for Medicins Sans Frontieres, which has mobile clinics in the delta, told The Straits Times that staff had noticed a 'significant number of diarrhoea cases', but it was not at the epidemic stage - yet.

The most critical needs were clean water and medicine to treat those with open wounds sustained from flying and floating debris.

Australia yesterday increased its aid contribution to US$23.4 million (S$32 million) in response to warnings at the weekend from disaster relief experts.

And the United Nations launched an appeal for US$187 million; within hours, US$77 million had been pledged, officials said.

Mr Jeyakumar said World Vision - whose help the junta officially requested, in addition to the Japan International Cooperation Agency and UN Children's Fund - was running out of relief supplies such as tarpaulin and plastic sheets.

But he said that there was a more urgent need for medical supplies now.

Local hospitals - damaged, and in some cases wiped out by the storm - are overcrowded and running out of medical supplies. Doctors and nurses are exhausted from working around the clock for a week.

One hospital in Bogalay was treating some 5,000 patients a day, according to a Reuters report yesterday.

A UN humanitarian agency said yesterday that the death toll could range from 63,290 to 101,682, and that 220,000 people were reported missing.

But Myanmar state-run TV reported last night that the number of deaths had risen to more than 28,458, and 33,416 people were missing.

Meanwhile, Myanmar's ruling generals said there was a 'massive turnout' for a national referendum to ratify a new Constitution, an Agence France-Presse report said.

In a story that made no mention of the cyclone tragedy, the New Light of Myanmar newspaper - a mouthpiece for the junta - said some places had to extend voting hours to let everyone cast their ballot, and that the referendum was held successfully.

nirmal@sph.com.sg

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